Congenital Breast Deficiency
Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery
Treatment Instructions
What Is Poland Syndrome? Poland Syndrome was first described in 1841 by Dr. Alfred Poland, who identified patients with an absence of the pectoralis major muscle. This syndrome is characterized by partial or complete underdevelopment of the pectoralis major muscle, often accompanied by other abnormalities on the same side, such as syndactyly (webbed fingers), digit deformities, and underdeveloped breasts. The severity of the condition can range from mild to severe and may also involve the serratus anterior, latissimus dorsi, or other muscles, as well as flattened or partially absent ribs. In some cases, it is associated with chest deformities like pectus carinatum (pigeon chest), pectus excavatum (funnel chest), or scoliosis.
The incidence of Poland Syndrome in international studies is reported to be approximately 1 in 10,000 to 100,000 live births. It is twice as likely to affect the right side compared to the left, and it occurs equally in males and females. However, female patients are more likely to seek breast reconstruction from plastic surgeons.
The exact cause of Poland Syndrome remains unclear. Hypotheses include abnormal vascular development, trauma during development, or genetic factors, but no definitive explanation has been established.
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Medical Center Specifications and Equipment
The operating room is equipped with Mitaka microscopes, of which there are only four in Taiwan. They have a resolution of up to 16 million pixels and can magnify 42 times optically. They are very suitable for the anastomosis of lymphatic vessels and veins of 0.5 mm and are often used in lymphatic venous anastomosis, such as preoperative evaluation and intraoperative evaluation of the permeability of sutures, making the operation more stable and safe.
Breast Reconstruction: Improving Appearance and Addressing Complications
Most patients with Poland Syndrome do not experience significant functional impairments, and hand deformities are often mild. Diagnosis involves taking a detailed medical history, including prenatal history, and performing a physical examination of the chest, shoulder, and hands. Serum immunological tests may be conducted to rule out other conditions. For patients with underdeveloped ribs, a chest CT scan is recommended. Reconstruction treatments include the following methods:
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Implant-Based Reconstruction
The earliest treatment for congenital breast deficiency involved the use of implants, such as silicone or saline. However, the results were often suboptimal. The absence of the pectoralis major muscle frequently leads to capsular contracture, resulting in a tight, unnatural breast shape. -
Tissue Expander Reconstruction
Another approach is to first insert a tissue expander, gradually inflating it with saline over 2-3 months to stretch the skin and create space. The expander is then replaced with a permanent implant, resulting in a more natural breast shape. However, there is still a risk of capsular contracture with this method. -
Autologous Tissue Flap Transfer
The latissimus dorsi flap can be used for reconstruction, but in some Poland Syndrome patients, this muscle may also be underdeveloped, and its fat content may be insufficient. In such cases, an implant is often required to achieve the desired volume. Additionally, the latissimus dorsi muscle may feel firmer than natural breast tissue. -
Autologous Fat Transfer
Using a DIEP (deep inferior epigastric perforator) flap, which transfers abdominal fat along with its nutrient blood vessels, offers a more natural result. This method avoids sacrificing the rectus abdominis muscle, is less painful, and provides permanent, soft, and natural breasts. This approach yields the highest patient satisfaction.
Contact Dr. Cheng For A Consultation
If you have Breast Cancer Related Lymphedema and would like to know more about the most advanced treatments, contact Dr. Cheng. Internationally recognized as a leading lymphedema specialist, Dr. Cheng can discuss treatment options, based on your individual case. Dr. Cheng is a member of the American Society of Reconstructive Microsurgery and has performed numerous VLN surgeries on breast cancer survivors and other lymphedema patients.