Lat transfer or 3D CAD custom implant - which procedure would achieve the best symmetry for missing portion of pec? (photo)

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

It appears as though you have a reasonable portion of your functional pectoral major muscle with an armpit fold (aka anterior axillary fold). Because of this, sacrificing the latissimus dorsi muscle is usually not indicated for simply improving upon this. Fat grafting results here will surely be a big disappointment. That leaves 3D custom implants as your best overall permanent option. Glad to help.

Hi, thanks for the pic! In your case you have a great looking/defined chest wall on the left and a Poland's syndrome chest on the right. Lets start from the outside towards the inside.... Your collar bone and shoulder girdle are mostly symmetric and hopefully the limb length on the right is full length, but that cannot be assessed on the pic. The skin itself is slightly deficient on the right due to the less full volume of the right chest. This will be corrected with whatever you choose to fill the volume out with- being a lat transfer- fat or molded silastic. The nipple is higher and will always likely be a little higher even when the skin stretches from the procedure. I would love to see a pic of the back to see the lat for transfer to ensure it is as well developed. The pec is a little fuller on top compared to the left. I would over first assess the fat for grafting and start with an initial procedure of maximal fat grafting to stretch the skin and then after the intial results settled in 4-6 months come back with a 3-d scan custome silatic implant to give the impression of the full pec muscle. I think this would yield the best results with the least donor deficiency.
thanks
OPS

It has been our long time experience that no other procedure comes close to latissimus Dorsi muscle transfer. In your case a partial muscle transfer will be needed to create symmetric, functional result. In person or teleconference consultation with a board certified plastic surgeon with experience in this procedure is recommended. Good luck.