Breast Reconstruction Using Saline Implants in a Woman with Poland Syndrome

ABSTRACT

Poland syndrome is a rare anomaly characterized by a unilateral absence of the pectoral muscles, ipsilateral syndactyly and microdactyly. Associated anomalies include defects of the ipsilateral ribs and costal cartilages, and breast parenchyma in women. Herein, a case of a 22 years old woman is reported. She had no right pectoralis major, ipsilateral breast parenchyma and anterior parts of the ipsilateral 2nd, 3rd, 4th and 5th ribs. Under general anesthesia, a tissue expander was placed laterally between the subcutaneous and intercostal tissues and anteriorly to the pleura. A repeated saline injection via the expander connected port induced tissue expansion. The total amount of injected saline was 550 cc, and the expander was replaced with a 300 cc prefilled saline implant. The other breast was augmented by insertion of a 150 cc saline implant for symmetry as this was requested by the patient. There were no specific complications, with the exception of a persisting ipsilateral axillary wrinkle. To remove this wrinkle, a combined latissimus dorsi flap may be helpful.