Video
Voiceover:
24-year-old Paul came to see Pixie, suffering from Poland’s Syndrome, where one of his chest muscles is missing. He’s been referred to see Dr Yannis Alexandrides about the option to give him a perfect pec.
Dr Alexandrides:
We have two, uh, main solutions here. The first one is a permanent solution, made of silicone, we will insert it under your skin to give the impression of a muscle.
Voiceover:
But there’s a less intrusive alternative to an implant for Paul, which will give him a quicker result. And that’s to use a cosmetic filler called Macrolane, which will last between 18 and 24 months.
Dr Alexandrides:
The material is made of hyaluronic acid, it’s a substance that is found in our own skin, so it’s a natural substance, and we inject enough volume in the gap to create the volume that we need to match the difference. The advantage of this procedure is that it is done under local anaesthetic, so you don’t need to go to sleep, and it takes approximately an hour. And within a week, you will feel healthy enough to go back to all your activities.
Voiceover:
A couple of weeks later, and Paul is back to see Dr Alexandrides, and has decided that the less-invasive temporary procedure should be his first option.
Dr Alexandrides:
So I’m going to use two points of entry, one will be here and one will be here, and a third one might be here. They’re all very small, okay? So the pectoralis muscle is attached to this part of the thoracic wall…the lower part of it is completely gone. It’s only the upper muscle that is in existence on this side. When you compare it to the other side of the chest, you’ll see that the thoracic wall is smooth and round. But here, it created this concavity, that starts right here and it’s all the way to here. So what I will be doing, I will be focusing to fill in the concavity with the hyaluronic acid.
Voiceover:
Dr Alexandrides starts by numbing the area with a local anaesthetic…
Dr Alexandrides:
We want to inject the anaesthetic into the whole area we’re going to be injecting, so the whole area is completely numb. I’m using this large needle, it allows me to do this job faster and uh, with less patient discomfort, because if I didn’t have this big needle, I would have, I would need to do multiple injections in the skin.
Voiceover:
...and then begins to insert the filler using a special needle.
Dr Alexandrides:
So yeah, this is a special needle, it has a flat tip, and it has the injection part underneath. So that means that the first part of the needle spreads the area where the material will go, and then the material comes from the back so it spreads evenly, so it’s really the best kind for this approach. So I feel with my left hand, and the right one to actually do the injection, so I make sure that this is evenly distributed under the skin. Okay, so we’re doing very well. What I’m going to be doing at this point is massage it a little bit, so make it more even.
Voiceover:
Halfway through the operation, and Dr Alexandrides is carefully comparing the two sides of Paul’s chest, to make sure that they’re even.
Dr Alexandrides:
This is a good spot to really assess the result, because you can compare with the other side. So obviously my aim is to create a symmetric result, so I’m comparing all the points of the pectoralis muscle, and as I said, right now there’s still a little bit of gap created here that I need to fill, but the lower part is looking good. So we need to focus it here. So now we’d like to see you sitting up, so slowly…
Voiceover:
After about an hour, the procedure is complete, but it’ll be a few days before the swelling goes down and Paul will be able to see the impact of the filler.
Voiceover:
A week later, and now Paul is back to the clinic to reveal the results to Dr Pixie.
Dr Pixie:
Hi Paul, how’re you doing, take a seat there.
Paul:
How’re you doing.
Dr Pixie:
Nice to see you. Paul, if you want to slip your jumper off and show me what’s happened and show me the difference between how it was the last time.
Paul:
Yeah.
Dr Pixie:
You’ve got a little bit of bruising here now, so is this uncomfortable?
Paul:
No, it’s fine.
Dr Pixie:
Are you pleased with the result when you look in the mirror?
Paul:
Yeah, I’m very pleased, yeah. It’s been like that for so long, so I don’t know, now they look perfect.
Dr Pixie:
And what are you looking forward to doing now that you maybe would never have considered doing, say, last year?
Paul:
I’m looking forward to, uh, taking my daughter swimming, which I wouldn’t have been able to do, and um, going on my honeymoon, I’ll be looking forward to that, going to the beach.
Dr Pixie:
Fantastic. Good. And you’ve never done that before.
Paul:
No, no, I shied away.
Dr Pixie:
Thank you very much for coming back to see me, and hopefully things will continue to improve. Best of luck with everything.
Paul:
Thank you.
Dr Pixie:
And I’ll leave you to get dressed.
24 year old Paul came to see Dr Pixie because he had never developed pectoral muscles on the right hand side of his body, leaving him with a peculiar chest appearance. Dr Pixie diagnoses Poland’s Syndrome a rare condition more commonly affecting males. The main symptoms of the condition are purely cosmetic so Paul goes to see cosmetic surgeon Dr Yannis Alexandrides. After discussion with Dr Alexandrides Paul opted for a temporary but less invasive solution to surgery which involved injecting a cosmetic filler into the affected side of the chest to give the illusion of chest muscle. After the swelling had gone down Paul returned to Dr Pixie to show off his newly acquired pec.
Patient Name: Paul Darroch
Condition: Poland’s Syndrome
Specialist: Dr Yannis Alexandrides, Plastic Surgeon
Clinic: 111 Harley Street
Length of procedure: Approx 1 hour
Yes
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Hi im 17 and have been diagnosed with PS. It affects my right breast and it is a lot smaller than the other. Also I have a large dip above and below it. I went to see a plastic surgeon who suggested a fat transfer from another part of my body. Am now on the waiting list to get it done :)
In response to all the comments below.. I am a 25 yr old female and was diagnosed with PS by the age of 5... I have very noticeable irregularity with my chest and it effects my entire right side front and back..I have little to no strength in my right arm and it's a lot thinner then the left ... My right breast is totally missing the nipple is present but that's it... luckily I am only an A cup so I can hide it with thick padded bras... I have looked into surgery but the option I was given was not nice and Prolonged for weeks to stretch the skin for an implant to go in. I have found after a bad relationship and being called abnormal and I should appear in a freak show I'm am now single and have been for 2+ years as I can't face meeting someone who thinks this is funny..so the result is shattered confidence and no self esteem. But as I am getting older I am finding my RH Side is aching terribly in my shoulder and I can't sleep properly I have even bought a brace to try to support it but to no avail? Has anyone else suffered this with PS..?
In reply to Jane - posted on 28 Jan 2012 00:50 - me too. I am 41, and everything that has happened to you, including all the surgery is the same with me. I can't help but cry when I talk about it too. Just a question - do you have an implant? Do you ever feel pain behind your implant?
Hi all, I'm a 27 year old female. I was diagnosed with PS as a child; it affects the left side of my body. The most noticeable area is my left arm - about halfway between my shoulder and elbow I am missing part of my muscle. Basically, it looks like I put a rubber band around my arm as a kid and left it on while the rest of my arm developed around it. I have always been extremely self conscious about the way my arm looks, and at 16 went in for brachioplasty. The surgeon had zero experience with PS, but was confident that lipo and the brachioplasty would fix it. It did not, and instead left me with a scar that runs from my armpit to my elbow. 11 years later, and I am trying to find a permanent solution. I'm getting married next March, and want this fixed beforehand. Meeting with a neurologist and plastic surgeon next month to hopefully find a solution! Has anyone had any experience with fillers or cosmetic implants in the arm?
I am a 26 year old male who also has poland syndrome. Its true that the effects of this deformity hits us more mentally than physically (cause of how other's may or may not react toward's it). Depending on the severity of the full effects ( affecting just one side, both side's of the pectoral muscle, either side of the shoulder's, arm's,back or etc), one's self esteem can be damaged by this greatly. I'll admit it has gotten to me more than what i should but hasn't stopped me doing over 6 years of Active duty in the U.S. Army in a combat m.o.s. (military occupational specialty). I work out alot and have had a dramatic change of how it looked before and how it looks now. Its changed so much that now no matter what i wear, never shirts always collars shirts,hoodies, n jackets, it shows still. If anyone has advice on Doctor's that provide aid for those of us with Poland Syndrome, please send it my way. To end this on a positive note, Its how we were born, how we were created so if it affects your way of life so, look into whatever you have to do to change that. Either way, its a part of you.
hey, i also have poland syndrome,, unlike the fella in the above video, i was missing both sections of my right pectoral muscle. And in janruary i had corrective surgery and the Norfolk and Norwich Hospital., They planned to take a small part of my right lat muscle and create a flap and move the muscle to where my peck should be. It was all going to plan until i would'nt stop bleeding, and had to go back into surgery. Initially it looked alot better than before, but after a few months i started to realise id lost alot of strength and i suffered alot of discomfort, and ocasional sharpe pains. I dont recommend anyone gets reconstructive surgery, unless they get an artificial implant.
Hello I'm a 38 yr old male w'PS. I just had surgery to even out my chest. I have to say I'm pretty excited about the results. I was teased a little when I was younger, but I was strong minded so it didn't destroy me. Working out will keep you healthy which is great, but it will change the deformity. Some type of Surgery is the only way to get some type of result. My advise would be research PS and the surgeon that you choose to do it. Finally look for realistic results because it will not be perfect. Good luck.
I had a typo...exercising will not change the deformity due to PS.
For all those looking for medical help, esp. for children: I have PS and have had many reconstructive surgeries since child at Shriner's Burns Children hospital in Boston, MA. Not only are their services 100% free they also aid with family accommodations and travel for those who come from other parts of the country or the world.They treat patients until the age of 18.
I am missing my left pectoral muscle and also have a somewhat dished chest (pectus excavatum). I have chest wall deformity on the side where the muscle is missing (the rib cage is slightly pushed out) and also have some scoleosis. Other issues I have are probably the effect of developing in the womb with the muscle missing. They include the left side of the body being somewhat off kilter - ears at different heights, one flat shoulder and one sloping shoulder, arms of different lengths and hips at different heights. I also have a heart murmer that sounds like a heart valve problem that may be caused by the chest deformity. When I buy a suit, I have to have the arm lengths adjsuted separately and each leg needs to be adjsuted separately for the cuffs. The sloping/flat shoulder issue means I can never get a suit to fit properly. I have never been able to get a doctor to really talk about the chest problem (I'm 59, so you would think that one would take an interest). Most of them just ignore it. One young resident one time said that I had pectus excavatum pullus, named for the chicken wing/breast appearance of the chest without the pectoral muscle. After reading these articles, I suspect he really meant "poland" rather than pullus. He was probably sleeping through his anatomy class. One thing I am interested in is whether this syndrome will cause an earlier death or will criple me as time goes on.
Hi, my daughter also has PS. It was apparent at birth, and now she's 11. I too am looking for the best surgeons out there. Was wondering if you ever got any information. I've researched, but can't find many options for a young girl her age. It is most definately affecting her self esteem, and it breaks my heart.
Please help !! my baby has poland syndrome and I want the best working on her hand and later her chest. Does anyone or can anyone refer me to someone who specialises in this ? As she is 8 month she now need help being a girl this will have a huge inpact to her life and the first steps are vital. Please channel 4 get in contact with me for this very rare condition and how I can help her. NHS doesnt seem to know much. I am sure more can be done in the dsy and age
Hi, my daughter also has PS. It was apparent at birth, and now she's 11. I too am looking for the best surgeons out there. Was wondering if you ever got any information. I've researched, but can't find many options for a young girl her age. It is most definately affecting her self esteem, and it breaks my heart.
Hi, I'm a 38 yr old female. I have ps, my right pectoral is missing. I have had several breast implants done on the nhs, to try and get things looking even.....I'm waiting on another referal coz they are really different since having my kids. I wish I could afford to go private, sometimes it feels like 'u get what u pay for'. I've grown up knowing what I've got but I'm still unable to talk about it without crying. I dread the day my kids ask why my boobs are different :-( My first surgery was at age 14
I'm 47 year old male who has been aware of having a missing pectoral muscle since puberty. Doctors have commented on it before but never offered any diagnosis. Until seeing the programme last night, I thought I was the only person in the world who looked like this. I have been lucky in that my life is full & I've never experienced predujice. However, I have always dressed considering how my clothes make my chest appear, doing my best to disguise it, & have never walked along a beach without a top on. Seeing this programme my not change that, but it has immediately adjusted how I feel about myself & my body in a positive way.