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Before and after correction of chest asymmetry due to Poland Syndrome and gynecomastia in a 28 year old man. He was born with a congenital difference of his chest wall, where the right pectoralis major muscle was absent, seen as an inner curvature of his right armpit (due to absence of the insertion of the sternal head of pec major). His left chest had developed normally, including some breast and fatty tissue.

He wanted to feel comfortable removing his shirt while swimming and at the beach, which he was not comfortable doing presently. He had researched Poland Syndrome and understood that perfect symmetry was not possible because some of his chest wall anatomy was missing. His goal was to improve his chest symmetry from one side to the other so that he felt less self-conscious.

His chest surgery involved ultrasonic assisted liposuction (UAL) of his left chest and breast tissue to debulk this area, together with removal of fat from his right armpit using liposuction. Fat graft was harvested from his lower abdomen (shown in the photograph where we are pinching his fat graft “donor site”). Free fat graft was added to his right chest to slightly build up its padding and contour.

Free fat grafting cannot build an entire breast after breast cancer treatment or fully correct a male chest wall difference due to Poland Syndrome. It can improve the donor site and subtly improve differences in contour. Fat was added to his right chest to partially fill in the hollow resulting from the absent chest wall muscle.

Follow up photos are shown nearly two years after surgery. He has achieved improved symmetry of his chest and breasts. Interestingly, his left areola shrank significantly with the UAL treatment and much better matched the right areola size and shape! His scars have matured and he is now going shirtless at the beach! His abdomen contour is also greatly improved.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton