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Breast and Chest Wall Reconstruction with the Transverse Musculocutaneous Gracilis Flap in Poland Syndrome

Huemer, George M. M.D., M.Sc., M.B.A.; Puelzl, Petra M.D.; Schoeller, Thomas M.D., M.Sc.

Plastic and Reconstructive Surgery: October 2012 - Volume 130 - Issue 4 - p 779–783
doi: 10.1097/PRS.0b013e318262f025
Breast: Ideas and Innovations

Summary: Poland syndrome is a complex chest wall deformity with unilateral hypoplasia of the breast and pectoralis muscle, with a missing anterior axillary fold in its most common form. The authors report their combined experience and technique with the transverse myocutaneous gracilis flap to reconstruct the chest wall and breast either alone or simultaneously. Between June of 2004 and July of 2010, 11 patients (two male patients) were operated on and 14 flaps were transplanted. The authors found that the transverse myocutaneous gracilis flap proved to be a very valuable microsurgical alternative for reconstructing the chest wall and female breast in Poland syndrome with autologous tissue. The flap provides the surgeon maximal freedom of flap insetting for optimal symmetry together with a very inconspicuous donor site regardless of unilateral or bilateral harvesting.


Stuttgart, Germany; and Linz, Austria

From the Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart; the Section of Plastic and Reconstructive Surgery, General Hospital Linz; and maz–Microsurgical Training and Research Center.

Received for publication March 28, 2012; accepted April 27, 2012.

The results of this study were presented at the Ninth Congress of the European Federation of Societies for Microsurgery, in Turku, Finland, June 12 through 14, 2008, and at the Fifth Congress of the World Society for Reconstructive Surgery, in Okinawa, Japan, June 25 through 27, 2009.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. No outside funding was received.

Petra Puelzl, M.D., Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Böheimstraβe 37, 70199 Stuttgart, Germany,

©2012American Society of Plastic Surgeons