About Poland Syndrome

Poland Syndrome is congenital, meaning it is present at birth. Sometimes the chest difference is subtle and difficult to identify in a newborn; therefore, most cases are not diagnosed until later on in life. The condition is rare, estimated to be in about 1 in every 17,000 births. However, because it does not usually limit body functioning, it often goes unreported, so the true rates are unknown and could be higher.

Males are much more likely to have Poland Syndrome than females, and it most often presents itself on the right side of the torso. Many individuals with this condition discover their differences around puberty when the body grows most and asymmetries become most apparent. It can present in a variety of ways, the most common of which is the unilateral underdeveloped, partial, or complete absence of the pectoralis major muscle on one side of the body (more commonly the right, it can also present on the left side) leading to a noticeable chest wall asymmetry. Other muscles on the same side of the torso can also be affected, such as the latissimus dorsi, triceps, and pectoralis minor muscles among others. There can be fat and hair distribution asymmetries, as well as differences in sternal and rib cage configuration. The nipple-areola complex may also be underdeveloped and higher in position on the chest.

In women, the breast on the affected side is usually underdeveloped or absent with a high-riding nipple-areolar complex and sometimes with a complete absence of the nipple, medically known as athelia. In severe instances, people with this condition may have short, underdeveloped fingers, shorter forearm bones (radius and ulna), or even webbed fingers, a condition called syndactyly.

What Causes Poland Syndrome?

The exact cause of Poland Syndrome is still unknown. It is considered a sporadic condition, meaning it typically occurs randomly and is not directly inherited from parents. Some researchers believe that it is related to the abnormal development of the branches of the subclavian artery during the first few weeks of gestation; the fourth to the sixth week when the limb buds of the growing embryo begin to form. Without adequate blood circulation during this critical time of development, the embryonic cells that were destined to form the specific muscles and related structures fail to receive adequate nourishment to develop fully.

Treatment for Poland Syndrome

Poland Syndrome Treatment for Men

For men with Poland Syndrome, Dr. Salibian can restore the natural appearance of a symmetrical masculine chest. The most straightforward procedure he uses to correct the chest wall is the creation and placement of a custom-made semi-solid silicone implant. Patients present with varying degrees of muscle absence and associated chest wall, sternal, and rib irregularities. This is a two-stage process where first a moulage or a mold is created to replicate the shape, three-dimensional geometry, position, and size of the opposite or non-Poland side pectoral region. This first step is performed in the office, and it takes approximately an hour to prepare, mold, and fine-tune the moulage.

Once the moulage has been made, we send it to Implantech Associates, Inc., a medical implant company here in California where the final sterile semi-solid silicone implant is manufactured per the specifications of the moulage and additional doctor’s notes and shipped back to our office. The second stage is the operative procedure where the implant is inserted from the patient’s axilla into the surgically created pocket under fibreoptic guidance. The incision is well hidden in the armpit of the patient.

Depending on your condition, lifestyle, and health status, Dr. Salibian can customize treatment to ensure your results are optimized for the best symmetry. In some patients, transposing the latissimus dorsi muscle (a large and flat back muscle surrounding the lower, side portion of the trunk) is used to replace the absent chest muscle and provide the appearance of symmetry without using an implant. For other patients, he may find that fat grafting alone may be adequate to restore symmetry. Fat grafting is a procedure that involves liposuction techniques to harvest fat gently from another area of the body, preparing the fat in a sterile fashion, and reinjecting it subcutaneously to fill the defect, smooth out, and balance the contour of the chest. Usually, the fat donor sites are the abdomen, lower back, and flanks.

Poland Syndrome Treatment for Women

As a woman with Poland Syndrome, you may have challenges unique to your biology. In addition to the varying degrees of the pectoral muscle absence seen in men, it often affects the development of the breast and nipple. The surgical methods Dr. Salibian uses to construct breasts for women with Poland Syndrome are similar to the methods used for breast reconstruction. He modifies the technique to achieve the best symmetry and contour to suit unique body and breast shapes.

Some reconstruction options include the use of a tissue expander first as a staged reconstruction with a later exchange to a breast implant. A tissue expander is a breast implant-like device that Dr. Salibian inserts into the chest wall and slowly fills with sterile saline to create a larger breast pocket over time. During the second stage, the tissue expander is removed and replaced with a permanent breast implant that matches the opposite breast shape, size, contour, and projection. He can also utilize fat grafting techniques to enhance breast symmetry. The nipple position is also corrected to best match the opposite breast. If the patient has athelia, or absent nipple, it can be created during the second stage from the skin of the breast mound itself and tattooed later to match the opposite nipple areolar complex.

Sometimes a latissimus dorsi muscle with its overlying skin from the back and a breast implant are used to create the breast mound and symmetry as a single-stage reconstruction. Dr. Salibian strives to achieve the best possible symmetry with the opposite breast.

Personal Consultation

As a highly regarded plastic surgeon who performs unique reconstructive surgeries for individuals with Poland Syndrome, Dr. Salibian has treated Southern California patients as well as those from across the United States, Europe, and the world. Our office assists out-of-town patients to arrange accommodations and nursing services if needed post-surgery.

Regardless of where you are coming from, the process begins with a thorough personal consultation. This involves a detailed medical evaluation to understand the extent and impact of the condition on your body. By examining the affected areas and considering your unique circumstances, Dr. Salibian will provide individualized advice tailored to your needs. For out-of-town patients, we recommend an initial telehealth consultation to meet with Dr. Salibian, discuss your condition, and plan for your visit to our office here in sunny Southern California.

“To be able to serve this unique community of patients that spans all ethnicities and from all over the globe is an extremely gratifying and humbling experience.”

– Dr. Salibian.

Custom Silicone Implant

Dr. Salibian is an experienced aesthetic and reconstructive plastic surgeon practicing in Los Angeles. One of the most gratifying and life-changing surgeries that he performs is the designing and placing of a custom-made implant for patients suffering from Poland Syndrome. Many of our patients living with this disheartening dilemma have never taken their shirts off in public or even in the privacy of their own homes.

For a custom silicone implant, the first appointment will involve a detailed physical examination and custom creation of the moulage (cast/mold). Dr. Salibian will form the mold out of a clay-like substance and send it to the lab for permanent implant manufacturing. This process usually takes 3 to 4 weeks. During this time, you would make an appointment with your primary care physician to obtain medical clearance for surgery.

See the remarkable Poland Syndrome treatment results for men and women in our photo gallery. To take the first step, schedule an appointment with Dr. Mossi Salibian by calling (310) 550-0750 or inquire using our online form today. We will assist you in finding an appointment time and date that best suits your schedule.

Cost of Poland Syndrome Surgery in Los Angeles

We will give you a comprehensive breakdown of the costs involved with the recommended surgical technique for your particular case.

To find out more about what Poland Syndrome correction surgery entails and Dr. Salibian’s skill in performing these intricate procedures, call his Los Angeles office at (310) 550-0750 or get in touch online. The final results are life-changing and very rewarding for Dr. Salibian, as they demonstrate the true artistic talent and skill required for such a surgery. We are here to guide you through the process of attaining physical balance and improved self-esteem.

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