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Poland Syndrome is a rare congenital condition affecting the breast, chest, and, occasionally the upper extremities on one side of the body.1 It was named after the anatomist who described the condition in 1841. Classically, the pectoralis major muscle is absent or underdeveloped in patients experiencing Poland Syndrome, and the overlying breast is small, misshapen, or absent with a small or malformed nipple and areola.
This condition is actually most common in men, with males being three times more commonly affected than females, and the right side is affected twice as often as the left.2 It is not inherited, meaning it is not passed on from a parent to their child, but is believed to be due to in utero spasm of the subclavian artery on one side during a critical time in development of the chest wall, resulting in atrophy or aplasia of the soft tissues and/or ribs on one side of the chest and breast.
As breast asymmetry develops during puberty in females with Poland Syndrome, young women often seek cosmetic correction of their breasts and chest wall. In fully developed women, there may be a smaller breast on the affected side or an absence of the breast altogether. The nipple and areola are often smaller and sit higher than the other side, or they may be absent. The underlying chest wall is often depressed or misshapen, and the normal contour of the pectoralis major muscle is missing. Each of these features can be corrected or improved by Plastic Surgery.
Most women seeking Poland syndrome reconstruction are looking to reconstruct their breast and/or chest wall. Correction of Poland syndrome can include breast implant reconstruction, insertion of specialized pectoral implants, free flap reconstruction, nipple and areola reconstruction, and other complementary procedures to improve the appearance of the breast. In men, free fat grafting is often planned for the affected side, with ultrasonic liposuction of the other side of the chest to create improved symmetry.
Seeking correction for Poland Syndrome is a deeply personal decision driven by the desire to restore balance, improve symmetry, and enhance overall well-being. At her San Francisco practice, Board-Certified Plastic Surgeon Dr. Karen Horton specializes in customized Plastic and Reconstructive Surgery procedures to address Poland Syndrome defects, helping patients achieve natural-looking, harmonious results tailored to their unique needs.
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Correction of Poland syndrome is appropriate for both men and women. Good candidates for reconstruction related to Poland syndrome include individuals who are healthy, physically fit, and of a normal body weight. Younger women should have finished puberty and have had stable breast size for at least a year before surgery.
Smokers, patients with diabetes, multiple medical problems, or blood-clotting disorders are often not good candidates for reconstruction. Morbidly obese patients have a much higher rate of complications and are advised to achieve a healthy BMI before reconstructive surgery. Your medical history and current medical status will be evaluated at your consultation. You may be asked to see your Primary Care Physician for a full physical examination and appropriate laboratory tests prior to being medically cleared for surgery.
A breast implant is usually inserted to replace missing breast volume on the affected side. Traditional implant reconstruction involves two stages: a tissue expander is placed in one operation, and a permanent implant is placed in a second procedure. However, a new technique that does not require tissue expanders as a preliminary step provides the most natural-looking results and enables breast reconstruction in a single operation is available as an exciting option for Poland syndrome patients in our practice.
A permanent, postoperatively adjustable breast implant is used to augment or create a natural breast form. It can be adjusted as needed after surgery to suit a woman’s body, curves, lifestyle, and individual aesthetic goals. Many of the steps of surgery are the same as for breast cancer reconstruction. Learn more here.
Custom-shaped implants specifically designed to correct chest wall asymmetry in Poland Syndrome are an option for many men seeking reconstruction.3 These pectoral implants, made of silicone gel, are custom-ordered following a thorough consultation, physical examination, and precise measurements taken in our office. The procedure involves implant placement through an incision, typically located beneath the breast or in the armpit. However, due to the absence of subcutaneous fat in the chest area, implants may create visible edges and appear less natural than reconstruction using the body’s own tissue.
The use of the body’s own tissue for reconstruction is called a “Flap.” A “Free Flap” is a specialized reconstructive procedure that transplants tissue from a donor area to reconstruct the breast, chest wall depressions, and any additional abnormalities or hollows in Poland syndrome.
Advancements in Microsurgery offer exciting new options for Poland syndrome reconstruction using the body’s own tissue and avoiding sacrificing major muscles. During this procedure, fatty tissue is taken from the abdomen or the inner thigh area and Microsurgically transplanted to the chest region as a Free Flap. While traditional flaps from the abdomen permanently sacrifice another major body muscle, such as the TRAM flap, we do not recommend this procedure for our patients; instead, we offer muscle-sparing surgical options.
Innovative, state-of-the-art reconstruction methods for Poland syndrome include “Perforator Flaps,” known as the DIEP flap, SIEA flap, and TUG (inner thigh) free flap. These surgeries are only performed by specially-trained Reconstructive Microsurgeons with a great deal of experience in breast reconstruction.
In some cases, free fat grafting (“lipofilling”) can help improve contour irregularities in the upper chest where the pectoralis major muscle is absent. This technique involves harvesting fat from another part of the body using liposuction and transferring it to areas that traditional reconstructive methods may not entirely correct, such as above a breast implant near the clavicle. Fat grafting is typically reserved for specific reconstructive needs rather than routine cosmetic enhancements.
Because not all transferred fat cells survive, some may be reabsorbed by the body, and calcifications can develop in areas where fat does not successfully integrate. These calcifications can sometimes appear as irregularities on a mammogram. As a result, fat grafting is generally recommended only for cases like Poland Syndrome or post-mastectomy breast reconstruction.
While some patients achieve their desired results in one session, multiple fat grafting procedures—spaced 3 to 6 months apart as serial procedures—may be recommended. Fat grafting is performed as an outpatient surgery and may or may not be covered by insurance.
If the nipple and areola is absent or malformed, a new nipple prominence and an areolar circle can be reconstructed. Nipple reconstruction can be done at the same time as breast correction or occasionally is performed as a second outpatient procedure 3-6 months later. Please see our section on Nipple Surgery for additional details about nipple-areolar reconstruction.
The Latissimus dorsi (LAT) flap is a traditional method for correction of the Poland syndrome chest wall. The Latissimus is the largest muscle in the body and is used in almost all activities of daily living. In Poland syndrome, because the major chest muscles on the front (Pectoralis major and occasionally Pectoralis minor) are already missing, to additionally sacrifice another major muscle from the back can increase potential weakness and deformity of the trunk, and makes little sense! For this reason, the LAT flap is not usually recommended.
In addition to our website and educational materials given to you at your preoperative office visit, please print out and read the comprehensive Preparing for Breast Reconstruction Surgery handout. This pamphlet, written by Nurses and Doctors at the hospital where your surgery will take place, describes in detail your hospital experience and helps to educate you on what to expect in the hospital and during your recovery.
Please also visit our Testimonials section to hear our patients’ experiences in their own words.
Please see our Preparing for Surgery section to learn about what happens in the operating room on the day of surgery. Please also visit the sections that describe the various reconstructive methods in Poland syndrome for details of each surgery option. Our Preparing for Surgery will teach you about preparing for your Poland syndrome correction.
Please see our Postoperative Instructions section, Special Instructions for Breast Implant Surgery and Recovering from Microsurgery for additional information about Poland syndrome recovery.
Will My Other Breast Be Balanced to Match the Poland Reconstruction?
A balancing procedure is often recommended for the opposite breast to match the reconstructed breast for all types of reconstruction. Balancing procedures may include a breast reduction, breast lift, or breast augmentation based on the details of your body, your Poland syndrome, and your method of reconstruction. Your surgeon will examine both sides of your chest and will recommend the procedure(s) that best meet your goals and that provide the best aesthetic results with the greatest balance and symmetry.
What Are Potential Risks and Complications of Poland Syndrome Correction Surgery?
When you are considering any type of surgery, you should be fully educated about potential risks and complications. Please see our Preparing for Surgery section to learn about risks and potential complications related to surgery and Postoperative Instructions for additional information pertaining specifically to Poland syndrome correction.
Where Can I See Before and After Photographs of Poland Syndrome Correction Procedures?
Please visit our gallery to see before and after Poland syndrome surgery results!
Will My Poland Reconstruction Be Covered by Insurance?
Corrective surgery for Poland syndrome may or may not be covered by insurance. Your personal financial responsibility for surgery depends on the specifics of your insurance plan and whether your surgeon is a participating provider for your particular plan. Our Patient Coordinator Mary will go over this with you in detail as we plan your surgery and will assist you in using your insurance to your greatest advantage.
How Do I Know Whether Poland Correction Option is Right For Me?
As women Plastic Surgeons, we intimately understand how a person’s feelings about their chest and breasts can influence their confidence, self-image and self-esteem. At your Poland syndrome consultation, your surgeon will spend a great deal of time with you to get to know you personally and take a complete medical history. We will explore your reasons for seeking Poland syndrome correction, examine your chest, and if you are an appropriate candidate for surgery, your options will be described in detail.
Where can I find Poland Syndrome correction surgery near me?
If you’re looking for Poland Syndrome correction surgery in the San Francisco Bay Area, Dr. Karen Horton is a Board-Certified Plastic Surgeon with extensive experience in reconstructive and cosmetic surgery. She specializes in procedures that restore symmetry and improve chest contour, including correction of tuberous breasts, gynecomastia, and other breast and chest rejuvenation techniques. Dr. Horton is dedicated to creating natural, long-lasting results tailored to each patient’s unique needs. Contact us today to learn more about your options for Poland Syndrome correction.
1 The Annals of Thoracic Surgery. Poland’s syndrome revisited. https://www.annalsthoracicsurgery.org/article/S0003-4975(02)04161-9/fulltext. Accessed Janaury 27, 2025.
2 Genetic and Rare Diseases Information Center. Poland Syndrome. https://rarediseases.info.nih.gov/diseases/7412/poland-syndrome. Accessed January 27, 2025.
3 American Society of Plastic Surgeons. Implants Made by Computer-Aided Design Provide Good Results in Patients with Rare Chest Muscle Deformity. https://www.plasticsurgery.org/news/press-releases/implants-made-by-computer-aided-design-provide-good-results-in-patients-with-rare-chest-muscle-deformity. Accessed January 27, 2025.
Dr. Karen Horton has either authored or reviewed and approved this content.
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Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the Pacific Heights District in the Pacific Professional Building.
Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
9 AM to 5 PM
Wednesday:
9 AM to 5 PM
Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
Closed
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
