16 yo with Poland’s syndrome presenting as partial absence of pectoralis major muscle at his right chest with hypoplastic or underdeveloped right nipple. Patient underwent a custom made silicone semi solid implant insertion. First a mold of the missing chest wall tissues was made out of plaster. This was sent to the implant manufacturing company, Implantech Inc., who then custom prepared the permanent silicone semi solid implant identical to the dimensions of the moulage. The final implant was inserted via an axillary approach and secured deep to the clavicular fibers of his pectoralis major muscle that were the only muscle fibers that had developed in this patient. Note the final appearance of his chest with acceptable symmetry and definition.