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Poland’s Syndrome Reconstruction – Surgical Procedure

Named after Sir Alfred Poland, a demonstrator of anatomy who was the first to describe in London in 1841 this disorder, which consists of a rare birth defect characterized by a series of malformations on one side of the body.

The severity of Poland Syndrome differs from one person to another; however two defects are always present:

  1. The end of the main chest muscle attached to the breastbone is missing
  2. The breast or nipple is underdeveloped

On the same side of the body, other defects may be present, including the absence of the neighboring muscle tissue such as a rib muscle (serratus), the underdevelopment of the shoulder and arm bone, the absence of underarm and chest hair.

In females, the breast on the affected side is also typically absent. The upper extremities may also show hypoplasia (short and webbed fingers).

Poland syndrome is sometimes difficult to diagnose, especially in mild cases. However, 1 in 30,000 live births are affected by Poland syndrome.

 

How is my case evaluated?

Three key determinants influence theevaluation of Poland syndrome’s severity: breast development, the existence of the back muscle (latissimus dorsi), and the degree of chest wall malformation.


Determining the chest wall abnormalities and the presence of the back muscle may require evaluation through computerized tomography (CT scan).

 

How is it done?
A thorough examination will help assess the surgical option that optimizes the success of the procedure.

1- In Females:

In female teenagers, the procedure will happen in two phases, as the breasts are still not fully developed at this age.

Therefore, a temporary breast reconstruction is performed during which a subcutaneous tissue expander is placed in the affected side and then gradually inflated to follow the pace of the development of the other breast. By placing this expander, I will also be preparing the skin to accommodate the final implant and back muscle. 

For patients with minor breast asymmetry, a one-stage reconstruction is performed. A permanent implant filled with silicone gel and saline component is placed, featuring a removable port. After surgery, I will progressively fill the implant through the port to achieve symmetry with the other breast. Once the patient reaches its full breast development, the port is removed through a small incision. In most cases, tissue expansion corrects the nipple-areola asymmetry; if it doesn’t, an additional minor surgical procedure is performed.

1- In Males:

In male patients, the chest deformity is corrected with the transposition of the back muscle (latissimus dorsi) around the age of 18 years. In the event of a minor rib abnormality, a simple transposition of the back muscle will be sufficient to achieve a symmetrical appearance. 

However, in case of severe abnormalities, this procedure is combined with the placement of a custom-made breast implant.

* It is recommended that six months prior to surgery, patients affected with Poland syndrome start practicing sports activities that help develop the back muscle (latissimus dorsi).

 

How long is the recovery?
The operation usually takes five hours and is performed under general anesthesia. The techniques described above allow the latissimus dorsi to perform the same functions as those of a normal pectoral muscle.

  

The patient will leave the hospital two or three days following surgery after the drains are removed, and will be able to resume work a week later and sports activities three weeks later.

In all cases, you will be given specific instructions on how to care for your surgical site, what medications to take in order to relieve the pain and reduce the risk of infections. Be sure to ask all the questions concerning what to expect during the recovery period.

Disclaimer: The info presented on this page is indicative and for generic use only. Each patient’s case is unique and will be studied by Dr. Chadi Murr for full assessment.