Journal of plastic, reconstructive & aesthetic surgery : JPRAS
September 3, 2026 · via Europe PMC
"Nipple-centered customized skin expansion for breast reconstruction in female patients with Poland syndrome: A reproducible protocol".
Baldelli I, D'Aietti E, Bruzzone M, Repetto M, Antonini A, Raposio E.
AI summary — for doctors, generated from the abstract only
A customized two-stage tissue expander approach improved nipple-areola position in women with Poland syndrome.
What was studied
Retrospective observational study of 24 women with Poland syndrome who had expander-based, two-stage alloplastic breast reconstruction from 2012 to 2023.
Key findings
- Sternal notch-to-nipple distance rose from 16.04 to 19.10 cm
- Midsternal line-to-nipple distance rose from 8.77 to 11.06 cm
- Higher BMI was linked to more residual asymmetry in exploratory analysis
Clinical relevance
Gives plastic surgeons a reproducible protocol for nipple positioning in complex chest wall asymmetry.
Who should care
Limitations
Small retrospective series without a comparison group, and symmetry was judged by measurements rather than patient-reported outcomes.
Consider customized expander orientation to correct nipple position in Poland syndrome, and counsel higher-BMI patients about residual asymmetry.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Poland syndrome in female patients is frequently associated with complex breast and chest wall asymmetry and requires individualized reconstructive strategies to achieve satisfactory symmetry while minimizing morbidity.
Methods
A retrospective observational study was conducted on female patients with Poland syndrome who underwent two-stage alloplastic breast reconstruction between 2012 and 2023. Customized positioning of anatomical tissue expanders was used to reshape the skin envelope of the affected hemithorax and correct vertical and horizontal nipple-areola complex malposition. Anthropometric measurements, including sternal notch-to-nipple and midsternal line-to-nipple distances, were collected preoperatively and postoperatively. Statistical analyzes were used to evaluate symmetrical outcomes and correlations with some variables, including body mass index (BMI).
Results
Twenty-four patients were included. Mean sternal notch-to-nipple distance on the affected side improved from 16.04 ± 1.47 preoperatively to 19.10 ± 1.32 cm postoperatively, whereas midsternal line-to-nipple distance improved from 8.77 ± 1.20 to 11.06 ± 0.98 cm. Higher BMI was associated with greater residual postoperative sternal notch-to-nipple asymmetry in an exploratory analysis.
Conclusions
The proposed two-stage alloplastic algorithm achieved measurable anthropometric improvement in nipple-areola complex positioning in female patients with Poland syndrome. By combining customized expander orientation with staged implant reconstruction, this approach provides a reproducible strategy for reshaping the skin envelope and facilitating final breast symmetry while limiting donor-site morbidity.
Level of evidence
Therapeutic, IV.
DOI
10.1016/j.bjps.2026.08.043
PMID
42777622
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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