Congenital synmastia, or absence of the intermammary sulcus, is a rare breast anomaly in the pediatric population. While acquired synmastia after breast augmentation is a well-documented entity, congenital synmastia is a rare condition with only four previous cases reported in the surgical literature. We describe the first patient with concurrent presentation of congenital synmastia and multiple fibroadenomas. A combined technique was used to both address the patient's breast lesions and correct the defect.
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