Author Topic: Muscle flapping in pec minor?  (Read 1839 times)

Offline skinnygyno

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Not entirely related to gynecomastia but there are some talented surgeons on this board so I will ask. I recently discovered that I am missing a section of my pec minor on the right side. I'm assuming it would be diagnosed as a mild case of Poland's syndrome. To someone outside the realm of bodybuilding it would be unnoticeable. To me, however, it is very evident. If you view my body from both the left and right sides there is a distinct difference. Clothing, even baggier clothing tends to cave in on that side of my chest because there is no tissue to support it. I don't believe the entire pec minor is missing because it took me a few years to even realize I had this condition. If you were to divide the entire pec into 4 symmetrical sections, the upper left section is most definitely non existent. Again if I were to post relaxed pictures it would take a few seconds to see, even if you know what you're looking for. But when I angle my chest right you can see there is a pocket of flesh missing. And I know that as I continue to build my physique the left side will keep growing and the hole will become even more noticeable. There has been a functional impact as well. I have been bodybuilding for several years but this condition has impaired my ability to perform exercises like the bench press. The right side of my body compensates by shifting load onto my rotator cuff. Progressing on these lifts has become impossible. I am quite distraught. Couple this with a mild case of gynecomastia and my pec muscles do not look aesthetic in any way. Viewing my body from the right side almost gives the impression of breasts because the upper chest caves in and the pec major protrudes out at the bottom due to the gyno tissue. 
I do not know the limits and capabilities of muscle flapping. I've heard of people with worse cases of Poland's syndrome having the procedure done. But I do not seem to be missing the entire pec minor. Would such an operation be viable? If so, would I be able to train the muscle and induce hypertrophy like any other? Thanks so much!

Offline Litlriki

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First off, photos would be extremely useful to explain what the issue is.  The pectoralis minor muscle is not visible, since it's under the pectoralis major muscle, which is what you see as your chest muscles.  You may have an incomplete form of Poland syndrome to account for an abnormal pectoral muscle shape, or you may have sustained some sort of partial tear of your muscle in the past.  The functional aspects of this should be evaluated in the event that you'd benefit from any physical therapeutic maneuvers to help with rotator cuff issues, and so on.  Correcting the appearance of the pectoralis muscle in Poland syndrome does not usually improve function.  Also, in most cases, the correction is a static correction and it may not look normal in all views with motion and activity. It sounds like the subtlety of your defect would likely make any solutions costly and challenging with very little gain. 
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Offline DrPensler

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I treat a large number of bodybuilders so I understand very minor problems can have a major effect in competitions. As a general rule bodybuilders are the most demanding patients and as a starting point we often have to agree that the patient will never be happy with the end result which will be improved to a degree from the preoperative state. Of course photos are always helpful.Poland's syndrome which is named after Alfred Poland a medical student at the time of the initial description was described in 1841. As is typical to the time frame, diseases were cataloged by a list of physical findings as the etiology of the disease was most often unknown."Poland syndrome includes the features of ipsilateral breast and nipple hypoplasia and/or aplasia, deficiency of subcutaneous fat and axillary hair, absence of the sternal head of the pectoralis major muscle, hypoplasia of the rib cage, and hypoplasia of the upper extremity." More modern descriptions have expanded things a bit. A key issue is the hypoplasia of the pectoralis major .You should note the pec minor is under the pec major and it is very difficult if not impossible to discern the shape and volume of the various heads.I suspect without photos on my end that you are referring to a problem in the pect major not the minor.
Muscle transfers are performed for functional improvement with an acknowledged sacrifice in appearance.So a muscle transfer to improve the cosmetic appearance would almost certainly be counterproductive in your situation.
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Offline skinnygyno

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Attached is a flexed photo that hopefully highlights the deformity. The lighting is not great and it was easier to see the divot at a lower body fat percentage. I spent some time evaluating the muscle and I think it is fair to say that if the pec was a square, and you divided that into two triangles, there is no muscle within the inner triangle. And the outer piece does not feel as firm as the undeformed pec. Coupled with gynecomastia, this gives a very undesirable look. I am depressed...


 

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