Synmastia: prevention and correction.

Synmastia is a condition of aberrant communication of the breasts. Apart from the rare congenital cases, this is usually a result of technical complications during breast augmentation surgery caused by an overdissection at the medial side of the pocket, over the sternum, in the subglandular plane; or overdivision of the major pectoralis muscle insertion along the sternum, in the submuscular plane. A multidatabase search about synmastia has been performed. Between November 2004 and April 2009, the senior author (G.S.) has performed 924 breast augmentations and his experience in preventing synmastia is discussed and compared with the literature. Accurate surgical plan, correct choice of implants' size, and correct surgical technique are the most important rules to prevent synmastia. It is difficult to correct synmastia: additional reoperations expose patient to risks, cost, and dissatisfaction. On the basis of the recent literature and personal experience, we propose some classifications and guidelines to prevent synmastia.