Poland syndrome: Chest wall and breast repair

Abstract

Introduction: Poland syndrome is a rare congenital disorder. Its main characteristics are deficiency of the sternocostal portion of the pectoralis major muscle and symbrachydactyly. However, it encompasses a wide spectrum of other chest, breast and upper extremity anomalies. Patients and Methods: The author’s personal experience with a small series of patients with Poland syndrome is retrospectively reviewed. Only chest and breast anomalies were surgically corrected. A bilateral augmentation mammoplasty using different size implants was performed in order to restore chest and breast asymmetry in female patients. The latissimus dorsi muscle was transferred in order to replace the absent pectoralis major in male patients. Results: Eleven adult patients were found. There were 8 female and 3 male patients (age 21-29, mean 23,5y). Two patients refused any kind of treatment. Nine patients (six females, three males) underwent surgical correction (right side n=8, left side n=1). The follow-up period ranged from 6 months to 14 years. There were no major complications. There was a minor complication (seroma) in a male patient after latissimus dorsi transfer, which resolved spontaneously. No capsular contracture has been detected to date and no revision or implant change has been necessary in any of the female patients. All patients were satisfied with the final outcome. Conclusions: The pedicled latissimus dorsi muscle is still the “golden standard” for replacement of the totally absent pectoralis major muscle especially in males. Breast implants are highly successful in correcting chest/ breast asymmetry (size and shape anomalies) in females. Remaining nipple/areola deformities can be easily tackled at a later stage.