23 year old female with left side affected Poland Syndrome with amazia, or complete absence of breast but present nipple areolar complex. She had partial absence of her pectoralis major muscle where the central and inferior pectoral muscle was not developed; but the clavicular fibers were intact. Note also the smaller and upper and lateral location of the nipple areolar complex. She underwent staged reconstruction with placement of a tissue expander for the first stage. This allowed slow expansion of the soft tissues of the left chest until a desired size was reached. She desired a slightly fully right breast as well. For the second stage in her Poland Syndrome reconstruction, she underwent an exchange of the tissue expander to a permanent breast implant by replacing it with a 385cc High Profile silicone gel implant on the left and a 190cc Low Profile silicone implant on the right. Fat grafting (135cc) to the left upper breast pole and lateral breast region was also performed at the time of the tissue expander exchange for better symmetry. She wears a 34C brasserie and is very pleased with the outcome.