Aesthetic improvements in Poland's syndrome treatment with omentum flap.
BACKGROUND
There are many techniques that can be used to reconstruct anomalous breast volume in Poland's syndrome, but repair of the stigmatizing deformities such as the transverse skin fold in the anterior axillary pillar, infraclavicular depression, and anomalous breast contours continues to be a challenge. This study aimed to demonstrate the superior results of laparoscopically harvested omentum flap to achieve these aesthetic improvements.


METHODS
Patients with Poland's syndrome from a clinical database were identified and their outcomes were studied.


RESULTS
In 15 consecutive patients with Poland's syndrome, the breast contour, the anterior axillary pillar, and the infraclavicular depression were treated with omentum flap and evaluated. Silicone implants were used beneath the flap in 80% of cases to improve symmetry. Flap consistency was similar to that of the natural breast and only a small incision in the breast fold was needed. The flap is extremely malleable, adapts to irregular surfaces, and has a long vascular pedicle. It does not leave a scar at the donor site as muscular flaps do. The omentum can repair small irregularities in breast contour, achieving a natural result different from all other flaps. Due to its malleability, it is possible to reconstruct even the extension to the axillary pillar, which is impossible with all other techniques.


CONCLUSIONS
The omentum flap technique is a means of repairing the deformities caused by Poland's syndrome and improves the aesthetic result with outcomes that seem superior to any other reconstructive option.
dos Santos Costa
Sirlei
S
Department of Surgery, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Bairro Rio Branco, Porto Alegre, RS, 90035-003, Brazil. sirlei@sirleicosta.com.br
Blotta
Rosa Maria
RM
Mariano
Mirandolino Batista
MB
Meurer
Luise
L
Edelweiss
Maria Isabel Albano
MI
D000293:Adolescent; D000328:Adult; D001940:Breast / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D010369:Pectoralis Muscles / Q000002:abnormalities; D011045:Poland Syndrome / Q000150:complications / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000002:abnormalities / Q000601:surgery*; D055815:Young Adult