Breast Reconstruction in a Female Patient With Poland Syndrome

Poland syndrome (PS) is a congenital anomaly characterized by unilateral hypoplasia or absence of the pectoralis major muscle, often associated with breast asymmetry. Achieving symmetry while preserving the contralateral breast remains a challenge in reconstruction. We present a case of a 19-year-old woman with left-sided PS, a fully developed right breast, and limited autologous soft tissue (body mass index 19.8 kg/m²). A 2-stage approach was performed: initial tissue expansion followed by implant-based reconstruction with fat grafting. A 395-mL microtextured polyurethane implant was placed, and 130 mL of fat graft was injected to optimize contour. The procedures were uneventful, and the patient achieved satisfactory symmetry in size. However, nipple-areola height asymmetry occurred, which the patient declined to have corrected. This report expanded on previous literature by illustrating how a hybrid expander-implant-fat grafting approach was tailored to lean patients with PS, offering a reproducible and less invasive strategy compared with traditional flap-based reconstructions.