Poland syndrome and breast assymetry
Poland syndrome is the syndrome in which the patient presents with a corresponding hypoplasia or lack of fat, muscles, bones, mammary gland and the nipple and other nipple on one side of the chest. In addition, it concerns the hair growth of the armpit and the development of the corresponding upper limb (short comping or palatation). The absence of the sternal portion of the pectoralis major is considered the least pronounced in Poland Syndrome. The right side of the chest presents this problem twice as often as the left.
It has not been counted how many people suffer from Poland syndrome, because mild cases are usually not recorded. It is estimated that 1 in 30,000 people suffer from Poland Syndrome. Men are more likely to have this problem than women. Sir Alfred Poland, an English surgeon, was the first to observe and describe the syndrome in 1841, when he was still a medical student.
Main features of Poland Syndrome
The main features in Poland Syndrome are partial or total aplasia of the pectoralis major muscle and aplasia or hypoplasia of the breast, including the halo nipple-nipple complex. The syndrome may be accompanied by other congenital malformations such as lateral cartilage aplasia, neighboring muscles such as the anterior dentate gyrus, which ends in the ribs, may be absent, and the back muscles, such as the broad dorsal, may also be absent. subcutaneous fat and hair in the armpit, the contraction of the unilateral hand, etc.
In most cases, the aesthetic problem faced by the woman with Poland syndrome is that one of her breasts is hypoplastic or aplastic and that the delimitation of the armpit is unclear (because all or part of the pectoralis major muscle is missing).
Plastic breast reconstruction is usually done using a temporary or permanent tissue dilator (Becker). After the skin is stretched, it is decided whether it will be necessary to transfer part of a muscle of the back, usually in men (of the broad back) and subcutaneous fat, and less often the islet of skin above the muscle is used. This tissue reshapes the existing breast, with or without the use of a silicone implant, so that it is symmetrical with the other while restoring the smooth aphorism of the thorax from the axillary cavity.
The areola is usually created with a tattoo technique while the nipple with local flaps or with the transfer of a free complex implant from the unilateral nipple. The operation leaves only a scar on the back and armpit that is hidden by the bra. In addition to the silicone implants available for women, corresponding implants that resemble the shape of a man’s breast can also be used for men.
In some other cases, liposuction and tissue transfer by microsurgical techniques may be preferred (DIEP, SGAP, IGAP) to cover an implant and give the extra required volume to the area. The unilateral breast may need a mammogram to achieve symmetry.
With the innovative methods of plastic surgery, patients suffering from this syndrome can very quickly return to their daily lives and integrate into society without facing problems of social marginalization or psychological pressure in terms of their appearance.