Single-stage reconstruction of the chest wall combined with simultaneous augmentation
mammoplasty and transfer of an island pedicle
myocutaneous flap of latissimus dorsi muscle are major improvements over previous multiple-stage procedures that provide less satisfactory cosmetic results in management of patients with Poland's syndrome. Utilization of the single-stage technique in 2 patients demonstrated its efficacy as proven by excellent cosmetic results. In 1 patient with absent second, third, and fourth costal cartilages and ribs,
Marlex mesh covered with a synthetic dura mater graft was employed to stabilize the chest wall. Simultaneously, an island pedicle
myocutaneous flap of latissimus dorsi with its neurovascular bundle preserved was transferred to cover the
prosthesis. The other patient had a coexistent
pectus carinatum defect, which was repaired by resection of the costal cartilages and
osteotomy of the sternum without use of
Marlex. The
breast implant was covered concomitantly with the
myocutaneous flap of latissimus dorsi. No morbidity or mortality occurred. The cosmetic and functional results are superior to those obtained with standard techniques.