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Correction of unfavorable ourcomes in breast surgery-Synmastia or “uniboob” in Beverly Hills/San Fernando Valley

Synmastia is an unfavorable presentation after implant surgery where the medial “inner” part of the pocket dissection is slightly overdone, as a result, the patient loses the natural cleavage space and the medial definition is altered. Although it is rather uncommon, it typically requires surgical adjustments to the pocket. Most recently we have implemented the use of biologic grafts “strattice,” as an example, to support the medial border with such revision cases.

Synmastia is a condition where the soft tissue connects/webs both breasts across the midline anterior to the sternum. This condition gives off the appearance that the breasts are one “uniboob” and the implants look as though they are in fact kissing at the individual’s midline.

Case: This patient is a 30+ year old female who presented with displeasure with her breast implant appearance following her initial implant insertion. After a thorough evaluation and physical examination, I concurred with her complaint and verified that she did in fact suffer from an element of the unfavorable sequelae known as synmastia. The surgical advice was to bilaterally remove and replace the implants and insert a biologic graft to support the medial “inner” aspect of the breasts. The purpose of the biologic material was to help hold the implant in place and further prevent the synmastia from reoccurring. In surgery, the previously placed silicone implants were removed and replaced with smooth wall, high profile silicone implants with a fill volume of 350 cc bilaterally.