Correction of acquired synmastia with muscle-splitting biplane implant replacement.

[BACKGROUND] Synmastia following mammoplasty is an uncommon complication. The true incidence is not known and the condition is underrecorded and undertreated. Medial capsulorrhaphy is the treatment of choice and can be accomplished in a single or staged procedure. Muscle-splitting submuscular biplane is used to correct synmastia following subglandular mammoplasty. The procedure allows the use of undisturbed submuscular anatomy and obviates the need for capsulorrhaphy.

[METHODS] A retrospective single-surgeon record of over 1900 implant-related surgeries included five patients treated for synmastia. Four had their primary surgery done by the author and one was a secondary referral. Only one patient was aware of the condition and revision was done exclusively for synmastia. The other patients requested bigger implants without being aware of the condition. All five had their mammoplasty done in the subglandular plane and the pocket was changed to a muscle-splitting biplane without capsulorrhaphy. One patient had associated bottoming down and so her inframammary crease was relocated and repaired with multilayer capsulorrhaphy of the lower pole only.

[RESULTS] All five patients had acceptable results after synmastia correction.