Treatment of congenital symmastia can be challenging and could benefit from liposuction of the between the breasts (sternum area). The use of compression gauze and a “t-bra” will help put pressure on that area for improvement in contour.In general, it may take several procedures to achieve a separation. If the patient withcongenital symmastia is also interested in breast implants, there is an option to have breast implants placed as well as the liposuction of the cleavage area in one surgery and then after healing and recovery, proceed with a 2nd surgery to perform internal sutures (capsulorrhaphy) for better definition and contour of the cleavage area. Patients with congenital symmastia must have realistic expectations.
PATIENT / SURGICAL EXAMPLE
This 26 year old teacher from out of state had been thinking about breast surgery for over 20 years. She and her husband had been searching for the best plastic surgeon who had the confidence to improve her situation. She previously had the Nuss procedure for her pectus excavatum and had a metal bar place across her chest. She also has symmastia with webbing and excess skin of the cleavage area.
The markings below are a “road map” for your surgeon throughout the procedure. The “green” area is the skin tenting and the area where liposuction will be performed to achieve more contour. The “red arrows” indicate where the patient wants more fullness from the breast implants.
The surgeon injects tumescent fluid prior to performing liposuction to help with anesthesia and control bleeding during the procedure.
The patient was very unhappy about the skin webbing across the bottom of her chest. She already had a scar across her chest from the Nuss procedure so the doctor recommended using the same scar and excising the excess skin. The patient was very happy with that option.