Poland syndrome surgery

POLAND SYNDROME SURGERY IN SPAIN.

A very advanced new technique makes possible the correction of Poland syndrome. It’s possible to create a custom-made implant based on the chest deformity. Sometimes the implant is combined with fat transfer.

The implant replicates the contour of the pectoral muscle and the fat transferred hides the inevitable edges of the implant which can be seen subcutaneously.

A custom-made implant is created based on the chest deformity by means of a computed tomography scan. The implant can be reshaped and adjusted in situ during the surgery so that the contours are noticed as little as possible.

Many patients travel to Spain to undergo Poland syndrome surgery with 3D implants from Anatomik Modeling.

Poland Syndrome surgery requires a surgeon with wide experience and who is at the forefront of the most advanced techniques.

What is Poland syndrome?

Poland syndrome (also Poland’s syndactyly, Poland sequence, Poland anomaly) is a rare birth defect characterized by a partial or total underdevelopment of the chest muscle on one side of the body and on occasion the fingers on the same side (shorter or webbed fingers).

Poland syndrome is more common in men than women and is usually associated with the right side.

Poland Syndrome can also involve the ipsilateral absence of ribs, axillary fold and distortions of the hemithorax. It can include a variety of ipsilateral torso defects and defects in the upper limbs, including agenesis of the anterior portions of ribs 2 to 5, deformity of the sternum. It can also include absence of the latissimus dorsi, serratus, internal and external abdominal oblique muscles. The chest tissues could be small or absent and the areola nipple complex could be small, slightly pigmented and displaced towards the armpit.

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 with Poland syndrome, the team of plastic surgeons at Antiaging Group Barcelona (Spain) prefer to use implants and to transfer the patient’s own fat.

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.

In athletic and slim patients, who don’t have enough fat, implants give very satisfactory results especially if they are custom-made.

The AnatomikModeling Company creates a custom-made implant based on the chest deformity by means of a CT (CAT) scan. The implant covers and fills in the entire defect and it is implanted following the technique of professor Chavoin (world renowned pioneer in AnatomikModelling implants). It can be reshaped and adjusted in situ during the surgery so that the contours are noticed as little as possible.

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 alternative to silicone implants would be the insertion of chest (pectoral) gel implants. The team of plastic surgeons at Antiaging Group Barcelona (Spain) have 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.

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. Normally between 300 and 400 grams of fat are injected in.

It is important to bear in mind that regardless of the technique chosen the final result is static, in other words, exercise doesn’t modify it, so the patient himself will have to modulate the volume of the pectoral muscle on the healthy side.

The team of plastic surgeons at Antiaging Group Barcelona (Spain) is the only Spanish centre of reference for AnatomikModeling.

Doctor Jesús Benito’s team has received theoretical and practical training on the computerized construction of 3D implants and the distinct intervention techniques (pectus excavatum, Poland syndrome or other absence of muscles).

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.

Is it possible to use the new implant technique of AnatomikModeling to operate on patients who have already been operated on for Poland syndrome using traditional methods?

Yes, it is possible. The new technology allows us to improve the results of patients with Poland syndrome. For patients who have already had an operation for pectus excavatum or Poland syndrome, one of the great advantages of the AnatomikModeling implant is that the prototype is made from the CT (CAT) scan images which by computer engineering reconstructs the defect in 3D, which is still there despite having an implanted prosthesis. Until now, the reconstruction of the defect could not in many cases be complete, but with these moulds developed using computer-aided design the defect is filled in a way that is almost perfect.

Each patient with Poland syndrome is unique and special and needs a prior evaluation to decide if the re-operation is really worthwhile, which scar to do it through and where exactly to place the implant. For all of this, we recommend a visit with our team of specialists in surgery for Poland syndrome at the Antiaging Group Barcelona (Spain) clinic to be able to offer the best option.

There is a solution to Poland syndrome, but it requires treatment by a surgeon with wide experience in this field.

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 with Poland syndrome when they are teenagers, while men are usually treated later. Surgery for women with Poland syndrome 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, a TRAM or DIEP flap, and/or a latissimus (dorsi) muscle transfer, all of which can give shape and volume to the impaired upper wall. A fat graft is also a good option to hide the contour of the implant and achieve better symmetry for patients with Poland syndrome.

The treatment of Poland syndrome in women differs from the treatment in men due to the mammary gland. In the case of women, it is necessary to reconstruct the breast. Depending on the atrophy (wasting) that exists, it may be necessary to turn to various combined techniques. It should be kept in mind that sometimes the reconstruction is done before the patient has stopped growing, and therefore it is very possible that they will have to be operated on again in the medium or long term to adjust volumes.

Techniques that are usually used on women for the correction of Poland Syndrome:

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 does Poland syndrome surgery cost?

Poland syndrome surgery cost depends on the physical features of the patient and of the technique used in the surgery. Without meeting the patient we don’t offer approximate prices as each patient is a different case. But we know that the economic factor is important when it comes to making a decision. Therefore, we offer the possibility for the patient to come to our facilities for a first, free, no-obligation visit. The patient can consult with the surgeon regarding all their doubts and worries. Based on the characteristics of each patient, we will offer the best solution for each case.

Why choose doctor Benito for your Poland syndrome surgery?

Doctor Jesús Benito is known worlwide for his technique to correct the Poland syndrome by using custom-made Anatomik Modeling implants.

Antiaging Group Barcelona is the only centre of reference in Spain for Anatomik Modeling.

Poland syndrome correction surgery using custom-made implants is a personalised, safe and easy surgery which avoids open chest surgery and its possible complications.

With more than 20 years of experience, Doctor Jesús Benito is a recognised authority in Spain in plastic, reconstructive and cosmetic surgery.

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 to analyse your case and offer you the best solution.

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