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The chest wall deformity in Poland's syndrome varies from a minimal expression of pectoralis major sternal head hypoplasia to complete aplasia of the breast, chest musculature, and skeletal abnormali-ties.1–3 Varying techniques for the repair of these deformities have been reported.4–7 In women, reconstruction of the breast and hypoplastic musculature has involved the use of customized implants, tissue expanders, and latissimus dorsi transfers. The latissimus dorsi muscle affords several advantages. The muscle, once rotated, can be used to recreate the del-topectoral fold by inserting it into the humeral fascia. Furthermore, the infraclavicular hollow frequently associated with these chest wall deformities can be greatly improved. Rotation of the latissimus dorsi also affords the surgeon submuscular placement of a mammary prosthesis when the breast is being enhanced. The advantages of submuscular implant placement are well known.8–16 However, the latissimus dorsi muscle flap, with simultaneous implant placement, has been associated with significant scars in the axilla and back and on the breast itself.17 I have found … |
