Q: Dr. Eppley, I have poland syndrome, dextrocardia and pectus excavatum. My left side chest is sunken because of pectus excavatum and heart is located on right side because of dextrocardia. I do not have any disabilities in my day to day activities but I’m not happy with the physical appearance of my chest. Also, since I got Poland syndrome the left side of my chest seems to be slightly smaller while compared to the right side. I had undergone a plastic surgery procedure a few years ago in which my back muscle was transposed to fill the absence of pectoralis muscle but still the shape is not good. After going through your website I felt you could help me to get my left chest same to look more like my right. I have been analyzing various options and I came across the application of kryptonite in filling up the dent due to pectus excavatum so I thought the same procedure can also be used for my case. But still the muscle is absent which may need fat grafting from other parts of the body or adjustment of LD muscle further. Please find attached photos for your kind review. I request you to kindly advise me on your recommendations.
A: I have taken a look at your pictures and what I see is a lack of pectoral/chest volume on the left side and a typical high positioned nipple. I do think you would benefit by volume addition but I would not use bone cement. Besides the fact that Kryptonite is no longer commerically available, it would be very difficult to get it in the right place and have a smooth contour. The chest volume you are missing is much more than a cement can do anyway. I would use a modified pectoral silicone implant as you already have the LD muscle flap coverage for it. It could be inserted through the upper end of your midline abdominal scar. This would add volume without increasing scar burden. In addition, I would do an inferior crescent nipple lift to move it downward. This would not create complete horizontal nipple symmetry with the other side but would be helpful. Usually you can get about a cm. nipple movement. These would be two helpful manuevers to lessen your current degree of chest asymmetry.
Dr. Barry Eppley