Novel technique for repair of symmastia using external negative pressure therapy for continuous pre-sternal compression

Symmastia, a term used to describe the medial intermammary confluence that may appear as a complication following breast augmentation or reconstruction, is a cosmetic issue breast surgeons occasionally encounter and must be prepared to correct. Over-dissection of medial structures, oversized implants, and forces applied to implants in the sub-pectoral space have all been proposed as potential causes of the development of symmastia. Numerous techniques to correct symmastia have been described in previous literature, including capsulorrhaphy, dermo-sternal adhesion, neo-pocket creation, and techniques based on muscle repair. However, these methods are susceptible to recurrence. In this case report series, we present three cases in which symmastia was successfully corrected following surgical repair with post-operative external negative pressure therapy over the intermammary sulcus.