Poland Syndrome is the name given to an affliction accompanied by a deficiency in fat and muscles on one side of the ribcage. It may also entail underdevelopment in the adjacent upper arm, hands and fingers.
Other malformations may manifest in conjunction with it, such as the Moebius and Kloppel-Feil syndromes. Poland Syndrome manifests on the right hand side of the ribcage twice as frequently as on the left hand side. This syndrome is much more common amongst men than amongst women.
The affliction is as such based on the name of Sir Alfred Poland, an English surgeon, who was the first to observe and record the syndrome in 1841.
Cause of Poland Syndrome
Poland Syndrome is likely caused by the obstruction of blood flow into the subclavian artery during the sixth week of gestation. The reduced flow of blood directly leads to reduced development in the ribcage and the adjacent upper limb. When an artery closer to the heart is blocked, the syndrome may manifest through much more pronounced symptoms. When arteries in different areas throughout the body become blocked, this can result in similar afflictions, such as the Klippel-Feil and Moebius syndromes.
Symptoms may differ from patient to patient. The affliction results in only minimal invalidity or dysfunctionality. For this reason, many patients only seek medical attention at an advanced age. The Syndrome does not damage intellectual ability.
The symptoms can be divided into two main categories:
1) Muscular: Certain pectoral muscles are affected, and may even be entirely absent – in particular parts of the pectoralis major muscle, as well as the entire pectoralis minor.
2) Mammary: The breast and nipple are insufficiently developed.
Aside from the aforementioned symptoms, patients may also exhibit the following:
1) Neighbouring muscles may be absent, such as the serratus anterior, which reaches the sides, as well as back muscles such as the latissimus dorsi.
2) Some of the oblique muscle may be absent or atrophic.
3) The scapula or shoulder blade may be smaller and at a higher position than is usual (also known as Sprengel’s deformity).
4) The upper arm and hand may be underdeveloped.
5) Fingers could be shorter,
6) Patches of body hair may be absent from the upper arm.
7) Fat atrophy may be present
X-ray scans of the ribcage and CT scan can aid in the diagnosis. The aforementioned symptoms may appear in a lighter or heavier form. Patients with lighter symptoms usually do not approach a doctor, and as such remain undiagnosed.
Poland Syndrome Treatment
Treatment is determined by the extent of the problem. For light cases of Poland Syndrome, breast augmentation and the placement of an artificial nipple, if needed, are usually sufficient to correct the problem. This treatment follows the exact same procedure of augmenting the breast as when augmenting underdeveloped breasts. In addition to the silicone implants available for women, further implants, in the shape of the male chest, can be used by male patients. In other cases, fat transplantation can cosmetically improve the affected area considerably.
The artificial nipple is usually a tattoo.
When there is a muscular deficiency the plastic surgeon may transfer muscles from the other, healthier side of the ribcage, or from any other area of the body. Artificial sides may also be used.
The procedure has to be done when the body is fully developed. Fat injections can be performed even earlier.
As far as afflicted fingers are concerned, these can be reconstructed through various methods – alternatively, fused fingers may be divided (syndactyly).
Dr. Christopoulos method for Poland Syndrome
Poland Syndrome is a malformation of the body, consisting of the atrophy or complete absence of parts of the body. These usually refer to the upper limbs and thorax. The major problem consists in the absence of the pectoralis major muscle. A new method that Dr. Christopoulos has developed, published and is performing, is the correction of Poland Syndrome by fat transplantation enforced by the use of stem cells. This method presents major advantages. These consist of the use of autologous material which is better accepted by the human organism, relatively to the use of implants. The result is more natural and the complications rare and of small gravity. Up to now the methods existing are implant’s insertion, hyaluronic acid use and muscle transfer. The disadvantages were noticeable and were referred to as the delineation of the implant, very high cost and noticeable scars. The use of fat of the same organism as a filling material for Poland Syndrome’s reconstruction is the ideal method, which had the only disadvantage of fat absorption. This drawback has been eliminated by the use of stem cells which is contributing to fat survival.
Improving the appearance of a Poland Syndrome patient can do wonders for their psyche, and restore them to social and personal functions which they may have been prevented from engaging with until then.