Nowadays, Poland Syndrome reconstructive surgery is possible with a very advanced technique which can create a custom-made implant based on the chest wall deformity. Sometimes the implant is combined with fat grafting.
This surgery requires a plastic surgeon with wide experience and who is at the forefront of the most advanced techniques.
What is Poland syndrome?
Poland syndrome (also called Poland sequence or Poland anomaly) is a rare birth defect described by Alfred Poland in 1897.
Even if the cause is unknown, researchers have suggested that it may result from a disruption of blood flow during the sixth week of embryonic development.
It is characterized by a partial or total absence of the pectoralis muscle (chest muscle) on one side of the body and webbing of the fingers.
It can involve a spectrum of chest-wall deformities affecting, to various degrees, the rib cage, the chest-wall muscles, neurovascular structures of the ipsilateral arm and the overlying breast development. Sometimes, patients with Poland syndrome can develop
an elevation of the shoulder blade. These defects are caused by a subclavian artery supply disruption sequence.
Poland syndrome is more common in men and is usually associated with the right side.
HOW IS POLAND SYNDROME CORRECTED IN MEN?
Unlike women, surgery to correct Poland syndrome in men is usually done after adolescence. Currently transferring the latissimus dorsi muscle to the chest is avoided. Although theoretically it would be a good option, it involves sacrificing a healthy and useful muscle. As well as that, with time, the muscle could waste away and require the use of an implant.
In the case of men, the best option is to use implants in combination with fat grafting. The implant replicates the contour of the pectoral muscle and the fat graft hides the inevitable edges of the implant which can be seen subcutaneously.
By means of a CT scan (CAT), the AnatomikModeling Company creates a custom-made implant based on the chest deformity The implant covers and fills in the entire defect. It can be reshaped and adjusted in situ during the surgery so that the contours are noticed as little as possible.
Antiaging Group Barcelona is the only Spanish centre of reference for AnatomikModeling. Doctor Benito has received theoretical and practical training on the computerized construction of 3D implants and the distinct intervention techniques.
This plastic surgery should be carried out when body development has finished. It is very difficult to achieve perfect symmetry as the defect involves the absence of several tissues at the same time.
PROS AND CONS OF CUSTOM-MADE IMPLANTS.
The advantages of this surgical technique for Poland syndrome patients are the following:
- Customized and personalized surgery according to the existing deformity.
- Silicone material which is soft but solid: it feels like the sternum (chest bone), and definitive.
- The edges of the implant adapt to the defect and are also covered by the musculature.
The main disadvantage of this implant is the cost, as they are very expensive. But it needs to be kept in mind that these are lifelong implants which don’t need replacing, as they are made with silicone elastomer, not with gel.
THE PECTORAL IMPLANT: A LESS EXPENSIVE ALTERNATIVE.
The alternative to silicone implants would be the insertion of chest (pec) implant.
Doctor Benito has devised an innovative technique that makes the chest muscle that has been operated on look very similar to the healthy chest muscle. However, pectoral gel implants can’t be moulded and therefore don’t allow the result to be personalized. Nevertheless, they are an acceptable alternative and they are more economic than the implants that are custom-made.
FAT GRAFTING
In patients who have an excess of weight, fat in the abdomen or in the healthy breast, to insert an implant doesn’t satisfy the aesthetic requirements. In these cases, the best thing is to do a graft of the patient’s own fat.
Total remodelling is achieved: the contour of the abdomen and flanks (love handles) are improved, the excess tissue from the healthy side of the thorax is removed and the affected side is filled in a way that the contours achieved perfectly simulate the absent muscle.
HOW IS POLAND SYNDROME CORRECTED IN WOMEN?
In the case of women, Poland syndrome affects the development of the breast and causes significant asymmetry. For that reason, it is usual to treat patients when they are teenagers, while men are usually treated later. Surgery for women boosts their self-esteem and improves their body image.
The simplest cases of Poland syndrome in women can be treated satisfactorily with a breast implant. However, this option could accentuate the sunken subclavicular space and, because of the natural lack of parasternal tissue, the implant could migrate to this space. This causes bad positioning in the upper part.
For that reason, adjunctive treatments in the breast implant could include a:
– Customized implant
– TRAM or DIEP flap
– Latissimus (dorsi) muscle transfer
– Fat grafting to hide the contour of the implant and achieve better symmetry.
The treatment of Poland syndrome in women differs from the treatment in men due to the mammary gland. In the case of women, a total breast reconstruction is necessary. Depending on the atrophy (wasting) that exists, it may be necessary to turn to various combined techniques.
Procedures for a female Poland Syndrome reconstructive surgery.
Implants and/or expander. In the case of mild deficiencies an anatomic implant can be inserted to give volume and shape to the contralateral side. If there is significant asymmetry, it may be necessary to insert an expander which allows the skin to be stretched to create space, and substitute it later with the definitive implant.
The problem both of the expander and the implant is that the edges may be visible and give a somewhat artificial appearance. For that reason, sometimes it is necessary to combine an implant with a fat graft or with the transfer of the latissimus dorsi muscle.
Fat grafts. These are increasing in popularity in place of implants. If the adolescent has enough fat, the cells can be transplanted to the breast. In this way a greater versatility in the shape can be achieved and putting an implant in can be avoided.
Implants have a lifespan and so it is easy that throughout life they may need to be replaced (if the implant was inserted at 16 years old and the average lifespan for a woman in 85 years old, it is unlikely that the implant will last so long). The fat graft is a natural technique that allows for the modification of the shape and is a very effective way to do so.
Transfer of the latissimus dorsi muscle: this is necessary for thin patients who need to cover up the implant or expander so that they cannot be seen. The great advantage is that it also gives an adequate shape to the armpit area, very similar to that of the chest muscle (pectoralis major muscle).
The disadvantage is that a muscle has to be sacrificed and in the long term it could waste away and lose volume.
HOW MUCH POLAND SYNDROME SURGERY COSTS?
Poland syndrome surgery cost depends on the physical features of the patient and of the technique used.
Each patient is unique and special and needs a prior evaluation. For all of this, we recommend a first free visit with Doctor Benito to be able to offer the best option. The patient can consult with the surgeon regarding all their doubts and worries.
There is a solution to Poland syndrome, but it requires treatment and medical advice by a surgeon with wide experience in this field.
WHY CHOOSE DOCTOR BENITO FOR YOUR POLAND SYNDROME SURGERY?
With more than 20 years of experience, Doctor Jesús Benito is known worlwide for his technique to correct the Poland syndrome by using custom-made Anatomik Modeling implants.
Reconstructive surgery using custom-made implants is a personalised, safe and easy procedure which avoids open chest surgery and its possible complications.
Antiaging Group Barcelona is the only centre of reference in Spain for Anatomik Modeling.
Doctor Jesús Benito: Publications:
- Benito-Ruiz J. “Male chest contouring with Implants”. En: Encyclopedia of Aesthetic Rejuvenation through volume enhancement. Herman CK, Strauch B. (Eds), 2014, p 303.
- Tratamiento de síndrome de Poland en Hombres. III Congreso Ibérico de Cirugía Plástica, Estoril, 2 a 4 de junio de 2016.
- Aesthetic reconstruction of Poland syndrome in males. ISAPS Congress Kyoto 2016.
Book an appointment with Doctor Benito.
The first visit is free and without obligation.
You can contact us on WhatsApp or Viber at +34 657 460 421.
If you wish, you can send us some photos to have an estimate quote. Photos will not be stored and will be treated with the utmost confidentiality. Please explain the results you wish to obtain.
Antiaging Group Barcelona
Ronda del General Mitre, 84, 08021 (Barcelona, Spain)
Nearest Metro Stations: Les Tres Torres / La Bonanova
Antiaging Group Barcelona
Ronda del General Mitre, 84, 08021 (Barcelona, Spain)
Nearest Metro Stations: Les Tres Torres / La Bonanova
