Plastic Surgery Department, University of Lyon, Centre Léon Bérard, 28 rue Laennec, Lyon, France.
Aesthetic Plast Surg. 2010 Apr;34(2):218-25. doi: 10.1007/s00266-009-9428-7. Epub 2009 Nov 10.
The severe forms of Poland's syndrome, with thoracic deformity, were until now very difficult to treat, with treatment involving complex surgery and implant insertion. Results were, in general, inadequate and the appearance unnatural. Our experience with fat transfer for breast reconstruction led us to propose reconstruction of the breast and thorax by serial fat transfer.
Our patient had a very severe form of Poland's syndrome with agenesis of the pectoralis major and latissimus dorsi muscles and lack of fusion of the fourth costal arch. She was treated by fat transfer, or lipomodeling. Lipomodeling was developed in our team in 1998 to augment breast volume after autologous latissimus dorsi flap reconstruction. Because this technique and use of an implant were not possible, we attempted reconstruction by repeated lipomodeling. The patient underwent five sessions at intervals of a few months, the first in August 2001.
With 6 years of follow-up, the aesthetic, functional, and psychological results exceeded our expectations. In five sessions we were able to reconstruct a breast of natural shape, sensitivity, and consistency, and which was totally accepted by the patient. Mammography, echography, and MRI 1 year later showed a normal breast of fatty type.
Lipomodeling in Poland's syndrome is technically feasible. This original description of treatment of the severest form of Poland's syndrome, with impressive results and at the cost of limited constraints and scar sequelae, opens new perspectives and suggests extensive potential applications of lipomodeling in all disciplines related to the breast.
波兰氏症候群的严重型，伴有胸廓畸形，过去的治疗非常困难，需要进行复杂的手术和植入物置入。结果通常不尽如人意，外观不自然。我们在脂肪转移乳房重建方面的经验促使我们提出了通过连续脂肪转移来重建乳房和胸廓的方法。
我们的患者患有非常严重的波兰氏症候群，胸大肌和背阔肌缺失，第四肋弓融合缺失。她接受了脂肪转移或脂肪重塑治疗。脂肪重塑是我们团队于 1998 年开发的，用于增加自体背阔肌皮瓣重建后的乳房体积。由于无法使用这种技术和植入物，我们尝试通过反复脂肪重塑进行重建。患者在几个月的间隔内进行了五次治疗，第一次治疗是在 2001 年 8 月。
经过 6 年的随访，美学、功能和心理结果超出了我们的预期。通过五次治疗，我们成功地重建了一个形状、敏感度和一致性都非常自然的乳房，完全被患者所接受。一年后的乳房钼靶、超声和 MRI 检查显示乳房为正常的脂肪型。
脂肪重塑在波兰氏症候群中是可行的。这种对最严重型波兰氏症候群的治疗方法具有令人印象深刻的效果，而且只带来了有限的限制和疤痕后遗症，为脂肪重塑在与乳房相关的所有领域的广泛应用开辟了新的前景。
