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KMID : 0358820070340030346
Journal of Korean Society of Plastic and Reconstructive Surgeons
2007 Volume.34 No. 3 p.346 ~ p.351
Chest Wall and Breast Reconstruction in Poland¡¯s Syndrome
Oh Deuk-Young

Lee Paik-Kwon
Seo Byung-Chul
Rhie Jong-Won
Ahn Sang-Tae
Abstract
Purpose: As a rare congenital anomaly, Poland¡¯s syndrome has been known to show hypoplasia in breast and nipple, absence of pectoralis major muscle, and aplasia or deformity of rib or costal cartilage which has been reported to be more common in male. However, most patients who are seeking operation are female patients having one-side deformity. In the field of plastic surgery, the major surgical indications could be asymmetric chest wall depression in man or breast hypoplasia in woman. There are many reconstruction options according to the degree of patient¡¯s deformity: a prosthetic implant, breast implant with or without tissue expander, latissimus dorsi musculocutaneous pedicled flap with or without implant and/or tissue expander, and free tissue transfer with or without tissue expander.

Methods: The authors have treated 4 patients(2 male, 2 female) who had a diagnosis of Poland¡¯s syndrome. According to the degree of patient¡¯s deformity, all patients underwent correction of breast asymmetry and unilateral anterior thoracic hypoplasia with one-staged or two-staged reconstruction.

Results: All patents were satisfied with the results and there occurred no specific complications.

Conclusion: The authors propose the treatment plan for patient with Poland¡¯s syndrome, according to the degree of patient¡¯s deformity. In case of male patient with mild deformity, the prosthetic implant or latissimus dorsi musculocutaneous pedicled flap will simulate the missing pectoralis and improve the contour deformity. In case of female patient with moderate to severe breast asymmetry and upward displaced nipple areolar complex (NAC), NAC can be lowered with tissue expander, breast can be enlarged with autologous free flaps or latissimus dorsi musculocutaneous pedicled flap with implant.
KEYWORD
Chest wall and breast reconstruction, Poland¡¯s syndrome
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