PMC4413498_01
A 57-year-old female Poland's syndrome patient with a Baker III capsular contracture on her previously implant based right breast reconstruction
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F1
Volume deficits at the inner and lower poles of the right breast, and at the sternum are observed in association with ipsilateral upper limb anomalies
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F2
Clinical examination revealed hypoplasia of the right breast, absence of the right pectoralis major muscle, ipsilateral upper limb anomalies and pectus excavatum chest wall deformity without cardiac or respiratory impairment [Figure 2].
Computed tomography angiography of the chest shows a 2A1 pectus excavatum chest wall deformity according to Park's classification, as well as a hypoplastic appearance and a substernal displacement of the internal mammary vessels
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F3
CT angiography imaging of the chest and abdomen showed a 2A1 pectus excavatum chest wall deformity according to Park's classification [Figure 3], as well as a hypoplastic appearance and a substernal displacement of the internal mammary vessels.
A new subglandular pocket was prepared, and the flap vessels were anastomosed to the thoracodorsal artery and vein in an end-to-end fashion
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F4
At the same time a pre-shaped DIEP flap based on the size of the contralateral breast was raised and anastomosed to the thoracodorsal vessels [Figure 4].
The patient remains free of pain and aesthetically pleased at 24 months follow-up
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F5
Reconstruction of the depressed sternum and of the inner breast pole was achieved
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F6