The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients

Background: The lipomodeling technique has transformed the management of Poland syndrome-associated thoraco-mammary deformities. Complex type 3 cases with significant thoracic deformity often require a combined approach, including the latissimus dorsi flap, which is absent in about 10 % of cases. Th...

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Main Authors: Gwenola Mambour, Richard Vaucher, Simon Perez, Paul Frobert, Emmanuel Delay
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Pediatric Surgery Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949711624000704
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author Gwenola Mambour
Richard Vaucher
Simon Perez
Paul Frobert
Emmanuel Delay
author_facet Gwenola Mambour
Richard Vaucher
Simon Perez
Paul Frobert
Emmanuel Delay
author_sort Gwenola Mambour
collection DOAJ
description Background: The lipomodeling technique has transformed the management of Poland syndrome-associated thoraco-mammary deformities. Complex type 3 cases with significant thoracic deformity often require a combined approach, including the latissimus dorsi flap, which is absent in about 10 % of cases. These patients face therapeutic challenges. The breast-pectoralis flap (BPF), developed for breast reconstruction, allows transfer of tissue from the contralateral breast. This study aimed to evaluate the BPF's contribution to correcting severe thoraco-mammary deformities in Poland syndrome and associated syndromes. Materials and methods: We conducted a case series on five female patients aged 11–16 years between 2012 and 2024 to evaluate outcomes and complications of breast reconstruction using the BPF. Four had severe stage III Poland syndrome with marked thoracic deformity. One had sequelae from cystic lymphangioma treatment, lacking the latissimus dorsi and pectoralis major muscles, corresponding to severe stage III Poland syndrome. Evaluation criteria included aesthetic results, patient satisfaction, functional impact, and the number of lipomodeling sessions needed. Results: The BPF enabled thoraco-mammary restoration in all patients. Additional lipomodeling sessions achieved the desired morphological results. All outcomes were “very good,” with no flap necrosis or other complications. Patient satisfaction was rated “very good” in all cases. Conclusion: The BPF is a valuable technique for treating severe thoraco-mammary deformities in Poland syndrome and should be part of the therapeutic arsenal for complex cases. However, it requires a delicate procedure by experienced plastic surgeons.
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spelling doaj-art-4fdf14c6dbb44cdb91bd56943788eadd2025-08-20T02:24:45ZengElsevierJournal of Pediatric Surgery Open2949-71162025-04-011010018510.1016/j.yjpso.2024.100185The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patientsGwenola Mambour0Richard Vaucher1Simon Perez2Paul Frobert3Emmanuel Delay4Department of Plastic and Reconstructive Surgery, Léon Bérard Center, Lyon, France; Corresponding author.Department of Plastic and Reconstructive Surgery, Léon Bérard Center, Lyon, FranceDepartment of Plastic and Reconstructive Surgery, Léon Bérard Center, Lyon, FranceDepartment of Plastic and Reconstructive Surgery, Léon Bérard Center, Lyon, FranceClinique Charcot, Medical & Surgical Clinic, 51 rue Commandant Charcot, 69110 Sainte-Foy-lès-Lyon, France; Department of Plastic and Reconstructive Surgery, Léon Bérard Center, Lyon, FranceBackground: The lipomodeling technique has transformed the management of Poland syndrome-associated thoraco-mammary deformities. Complex type 3 cases with significant thoracic deformity often require a combined approach, including the latissimus dorsi flap, which is absent in about 10 % of cases. These patients face therapeutic challenges. The breast-pectoralis flap (BPF), developed for breast reconstruction, allows transfer of tissue from the contralateral breast. This study aimed to evaluate the BPF's contribution to correcting severe thoraco-mammary deformities in Poland syndrome and associated syndromes. Materials and methods: We conducted a case series on five female patients aged 11–16 years between 2012 and 2024 to evaluate outcomes and complications of breast reconstruction using the BPF. Four had severe stage III Poland syndrome with marked thoracic deformity. One had sequelae from cystic lymphangioma treatment, lacking the latissimus dorsi and pectoralis major muscles, corresponding to severe stage III Poland syndrome. Evaluation criteria included aesthetic results, patient satisfaction, functional impact, and the number of lipomodeling sessions needed. Results: The BPF enabled thoraco-mammary restoration in all patients. Additional lipomodeling sessions achieved the desired morphological results. All outcomes were “very good,” with no flap necrosis or other complications. Patient satisfaction was rated “very good” in all cases. Conclusion: The BPF is a valuable technique for treating severe thoraco-mammary deformities in Poland syndrome and should be part of the therapeutic arsenal for complex cases. However, it requires a delicate procedure by experienced plastic surgeons.http://www.sciencedirect.com/science/article/pii/S2949711624000704Autologous reconstructionBreast reconstructionLipomodeling techniqueFat graftingSevere Poland syndromeThoraco-mammary deformities
spellingShingle Gwenola Mambour
Richard Vaucher
Simon Perez
Paul Frobert
Emmanuel Delay
The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients
Journal of Pediatric Surgery Open
Autologous reconstruction
Breast reconstruction
Lipomodeling technique
Fat grafting
Severe Poland syndrome
Thoraco-mammary deformities
title The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients
title_full The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients
title_fullStr The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients
title_full_unstemmed The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients
title_short The breast-pectoralis flap: A major contribution to the treatment of severe thoraco-mammary deformities in Poland syndrome and associated syndromes - A case series of five patients
title_sort breast pectoralis flap a major contribution to the treatment of severe thoraco mammary deformities in poland syndrome and associated syndromes a case series of five patients
topic Autologous reconstruction
Breast reconstruction
Lipomodeling technique
Fat grafting
Severe Poland syndrome
Thoraco-mammary deformities
url http://www.sciencedirect.com/science/article/pii/S2949711624000704
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