Before and after bilateral breast revision in a 33-year-old woman with right Poland syndrome. She was born with congenital absence of the sternal head of pectoralis major muscle, seen as a divot above her right breast implant and an in-sloping curve in her right armpit. Her previous saline breast augmentation was asymmetric. She wanted to be a little larger and to have improved symmetry.
Bilateral capsulectomy and implant exchange was performed, inserting smooth round silicone gel breast implants. A left periareolar mastopexy lifted and centralized the left nipple and areola, and a small amount of free fat grafting was performed in the upper pole of the right chest wall.
We do not usually recommend fat grafting to a natural breast because of the risk of permanent changes in the breast such as calcifications, oil cysts and fat necrosis. In this case, fat was only added to the upper chest wall where the muscle was absent, not in the actual breast. The last photo shows intraoperative details of this revision procedure.
Follow up photos are shown 6 weeks after surgery.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
