Breast reconstruction is performed to recreate breasts after mastectomy, but it can also help men or women who are born with Poland Syndrome, a rare congenital condition. Poland syndrome is almost always sporadic (not hereditary) and tends to occur on the right side of the chest. The cause is unknown.
For individuals with mild cases of Poland Syndrome, one breast doesn’t mature beyond puberty, remaining smaller than the opposite unaffected breast. In others, the nipple and some or all of the breast tissue may be absent. In the most severe cases, part or all of the pectoralis chest muscle and underlying ribs and breastbone are underdeveloped or missing.
Men are more frequently born with this condition than girls. For them, a custom silicone pectoral implant can replace the chest wall defect and establish symmetry. For women who have little or no breast tissue, having Poland syndrome can be somewhat like being born with a mastectomy, and breast reconstruction procedures can help restore what Nature forgot, just as it does for women after mastectomy.
Repairing a woman’s Poland syndrome is more complex, because it involves replacement of more tissue. Fat grafting can help improve mild cases of the condition by replacing missing breast tissue. In more challenging cases, plastic surgeons use the same procedures as they do for women who have delayed reconstruction. Traditionally, this has been done with tissue expansion and a breast implant, or transferring tissue and a muscle in the back (a latissimis dorsi flap) or the abdomen (TRAM flap) to the chest.
Today, autologous tissue flaps, including perforator flaps (DIEP, TDAP, etc.) that transfer skin and fat but don’t require muscle, are also used to correct Poland syndrome deformities. The procedures rebuild the missing (or partially missing) breast by bringing healthy, living tissue to the chest. Tissue expanders may also be used, with or without an acellular dermal matrix.
Reference: National Institutes of Health, Library of Medicine. https://ghr.nlm.nih.gov/condition/poland-syndrome#statistics