Breast reconstruction in supernumerary breast and ectopic breast tissue in Poland's syndrome

Poland's syndrome is a rare congenital condition characterized by anterior chest wall malformations and, frequently, ipsilateral upper limb deformities. Treatment strategies vary depending on severity and may involve complex reconstructive approaches.

We present the case of a 20-year-old female with Poland's syndrome who exhibited left-sided supernumerary nipple and significant breast asymmetry. Clinical examination revealed two vertically aligned nipples and accessory breast tissue 6 cm lateral to the midclavicular line. The patient also presented with agenesis of the left 4th, 5th, and 6th ribs. Surgical management included excision of ectopic breast tissue and transposition of glandular tissue as a centrally based dermoglandular flap. Additionally, autologous fat grafting was performed to enhance volume and improve symmetry on the affected side.

Poland's syndrome encompasses a spectrum of chest wall and limb anomalies. Breast reconstruction in such patients is challenging, especially in the context of rib defects. Traditional expander or implant-based techniques are not always feasible. Our reconstructive approach preserved nipple-areola complex (NAC) sensation and glandular tissue, with emphasis on both aesthetic restoration and preservation of physiological function.

Reconstructive planning for Poland's syndrome should be individually based on anatomical constraints and patient expectations. In selected cases, autologous, minimally invasive techniques may yield optimal cosmetic results.