Treatment of Symmastia after Breast Reconstruction: Integration of Techniques

Abstract

Introduction: Acquired Symmastia (or synmastia) after breast implants is an uncommon complication after breast reconstruction. There are several techniques for correcting this complication, but there is no consensus. Methods: The surgical treatment of three cases of acquired retromuscular symmastia after breast reconstruction are described with the integration of techniques: points of adhesion in the intermammary groove, elevation of the anterior capsule flap with the creation of a neopectoral pocket (precapsular space) and exchange of implants. In two cases, the procedure was associated with fat grafting. Results: The patients evolved well, with correction of the symptoms and were satisfied with the esthetic result. There was no recurrence of the problem, with a follow-up from 9 months to 3 years. Conclusions: It is suggested an integration of techniques for the correction of symmastia (adhesion points and confection of a neopectoral pocket store with anterior capsule flap) after breast reconstruction, which can also be performed in cases of such complication after breast augmentation. This procedure can be associated with fat grafting for esthetic refinement and there may be an improvement in eventual contracture.