I am 27 and my breasts have always been different. One is easily a C cup while the other an A. I also have scoliosis and my chest wall caves in. Could this be poland syndrome? What type of DR could diagnose this? My OBGYN confidently tells me to see a surgeon and due to the extremity it should be covered by insurance, however, the surgeon's office quickly told me this is cosmetic unless caused by cancer. I desperately want this fixed and am looking for advice as to what my next step should be!
Is This Poland Syndrome or Simply Assymetry?
Doctor Answers (21)
The only way to start the process is by making an appointment and seeing a board certified plastic surgeon. You can be helped
Is This Poland Syndrome or Simply Asymmetry?
If you have not same problem in your hand, it is unlikely be Poland Syndrome, if you have scoliosis you need a very qualified surgeon.
You most certainly need to be evaluated by a board certified plastic surgeon. Insurance companies vary in regards to coverage. It is very important to know there are options for helping with these type of issues.
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Poland Syndrome can be mild, in the case of under-development of the breast or chest wall, to more extreme cases where the entire shoulder, arm and hand are affected as well. You did not include pictures so it is difficult to tell you much about your specific situation. I would suggest a consultation with a plastic surgeon who can examine you. It is possible that some insurance companies might cover this procedure if it is, indeed, a true Poland syndrome situation.
Assymetry in breasts or Poland Syndrome
Without seeing your photographs , it is difficult to suggest accurate diagnosis. The most qualified surgeon to make this assessment is a board certified Plastic Surgeon. Poland syndrome usually has many components. In severe cases the chest wall is underdeveloped, chest muscles may be hypoplastic and breast is consistantly smaller in contrast to the other side. Most of the times using different size implants could address the prblem, however occasionally more reconstructive procedures are required.
Poland's syndrome is a chest wall deformity of various degrees of severity from as littles as a small areola, to absent breast, to absent chest muscles, to absent underlying ribs, and arm deformities as well. Best to be seen in person regarding your issue.
You should see a Board Certified Plastic Surgeon
While asymmetry of the breast is very common, Poland syndrome involves the map-development of the breast, nipple, muscle, chest wall, and even the upper extremity on one side. An experienced plastic surgeon should be able to help you with an accurate diagnosis.
Poland Syndrome vs. Normal Breast Asymmetry
Hello and thank you for your question.
I would suggest going to a surgeon who has experience with Poland's Syndrome. I would ask this question prior to making an appointment with the particular physician. A plastic surgeon who does quite a bit of breast reconstruction may be your best bet. A diagnosis of Poland's Syndrome is made when you have absent breast on one side with a smaller or absent nipple on that side, usually the pectoralis major muscle (the pec muscle or bench press muscle) is absent or dimished in size as well. Sometimes there are abnormalities affecting the arm on that side as well. Most insurance plans cover reconstruction for this abnormality.
Pablo Prichard, MD
Thanks for your question, without a detailed physical exam I am unable to tell you. Poland's syndrome describes a series of congenital findings that represent chest wall malformation usually including abscence of a pectoral muscle. I have two important points. First, if you have been told you have Poland's syndrome-please seek the consultation of a very experienced surgeon- the condition can be challenging to correct. Secondly, physicians no longer decide what surgeries get covered. Certainly conditions like breast cancer reconstruction get covered by all insurance carriers while a purely cosmetic augmentation will not get covered by any. Your situation is somewhere in between. In my practice experience, most women with even severe breast asymmetry do not have true Poland's syndrome and no insurance funding was available. Even in the few patients with true Poland's syndrome, it has been much less then a 50-50 proposition that insurance carriers approved surgery. Good luck.
Structural changes of the chest. Is this Poland's Syndrome
Scoliosis and sternal deformities are well recognized issues in breast augmentation when it comes to symmetry issues. It is also not unusual to have on breast larger than the other by 2 or more cup sizes. Your changes are certainly congenital but not necessarily covered by insurance since insurance is coverage is only determined by medical necessity. If you have Poland's syndrome you would have an absent pectoralis major muscle or some variation of a smaller extremity on the affected side or hand abnormalities. Most plastic surgeons would be able to examine you and render an opinion.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.