Abstract
Medial confluence of the breasts, or symmastia, is probably not a rare entity, despite the paucity of the literature on the subject. It causes aesthetic disfigurement and problems with apparel and, in the case presented, was associated with chronic furunculosis or multiple pilonidal sinuses. Both problems were satisfactorily dealt with by means of a modified bipedicled vertical dermal flap technique with excision of the central part of the chest wall, where the skin lesions were present. The result was cosmetically acceptable.
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