Antiaging Group Barcelona. Clinica de Cirugia Plástica Estética.
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Poland syndrome (also Poland’s syndrome, Poland’s syndactyly, Poland sequence, and Poland’s anomaly) is a rare birth defect characterized by underdevelopment or absence of the chest muscle (pectoralis) on one side of the body and (but not always) webbing of the fingers (cutaneous syndactyly) of the hand on the same side (ipsilateral hand) mostly common on the right side of body and found more in males than females.In 1841, Alfred Poland, a 19-year-old medical student at Guy’s Hospital in London, England, published the classic description of the syndrome that bears his name
It is usually considered a unilateral condition.
The cause of Poland syndrome is unknown. However, an interruption of the embryonic blood supply to the arteries that lie under the collarbone (subclavian arteries) at about the 46th day of embryonic development is the prevailing theory
These deficiencies are largely cosmetic, with the most common (simple) form presenting as a unilateral absence of the sternocostal head of the pectoralis major muscle. The deformity can also be complex, with ipsilateral absence of ribs, axillary webbing, and foreshortening of the hemithorax. The complex can also incorporate a variety of ipsilateral torso and upper extremity defects, including agenesis of the anterior portions of ribs two through five; derangement of the sternum; and absence of the latissimus dorsi, serratus anterior, and external abdominal oblique muscles. The breast tissues may be small or absent and the nipple-areola complex can be small, lightly pigmented, and displaced toward the axilla
In female patients, mild cases may be satisfactorily treated with a mammary prosthesis. However, this option can accentuate subclavicular hollowing and, due to the natural tightness of the parasternal tissues, the implant may easily migrate into this space. This results in a high-riding, misshapen breast mound that is distressing. Additions to the mammary implant can include a customized chest wall implant, a TRAM flap, and/or a latissimus muscle transfer, all of which can provide shape and volume to the deficient upper chest wall. Fat grafting is as well a good tool to disguise the contour of the implant and get a better symmetry.
In male patients, the objective was to replace the missing pectoralis major, the better technique is to transfer the latissimus muscle to the chest. Although this is considered to be the best option most of patients do not accept to use a healthy muscle for that, so in mot of these cases we use a pectotal implant. The implant is turned clock or anticlockwise to mimick the healthy side and to recreate the contour of the pectoralis muscle. Fat grafting can be used to disguise the unavoidable edges od the implant that can be seen subcutaneously.
In complex casesin both sexes where there are missing ribs, the defect is treated with ribs and implants are not used because there is no a firm background. In these cases autologous tissues are the option of choice for reconstruction.
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Antiaging Group Barcelona: Plastic Surgery, Aesthetic Surgery, Aesthetic Medicina, Antiaging Medicine
Clínica Tres Torres, c/Dr. Carulla, 12, planta 3, 08017 Barcelona - Tel. 932 520 967
Consultas Externas La Milagrosa, c/Fernández de la Hoz, 45, 28010 Madrid - Tels. 902 013 713 | 606 95 33 31
Última actualización: May 24, 2013