Pectoral implant

[skinnygyno]

I am a bodybuilder blessed not only with gynecomastia (soon to be removed), but also a unilateral pectoral deformity. I have Poland's syndrome and was born without most of the upper chest on one side. Very noticeable just below the collarbone where my chest looks sunken in, because there is no fat or muscle tissue present. And then to the left my upper pectoral is very thick and well developed as a result of unilateral training. The difference is very noticeable in person. 
I have a hard time accepting things and this is one thing that I refuse to live with. I always look for an alternative, no matter how unrealistic. Ultimately I would like to be presented with a real solution through regenerative medicine/tissue engineering, but the field seems years away from what I require. I am very hesitant about the idea of an implant because I do not expect to be pleased with the results. I stay fairly lean-- 10-12% body fat, and there is no tissue for an implant to sit beneath. I am worried it would very evident that I had silicone in my chest. I have also read about stem cell fat grafting but there are few pictures available online relevant to my application. I imagine a fat graft would create a more realistic and less detectable appearance, but that is prone to re absorption. 
If there is a treatment in the world that can achieve a desirable look, I will pay any amount to receive it. I simply desire something that can at least come close to matching the musculature of my other side. 

[Dr. Elliot Jacobs]

Great question.  Quick answer is that we really don't have many good answers for treatment Poland's Syndrome in body builders.

Given you body fat percent, any implant placed under the skin would look totally artificial. The best results with implants, be they pectoral implants on a male or breast implants on a female, look best when there is enough thick tissue covering over the implant to disguise its outlines.  And with your low body fat percent, that would not work.

And fat grafts are limited in how much can be grafted at one time.  Further,they pose problems in how much will remain after one grafting session.  More than likely, multiple grafting sessions would be required.  And then, even if successful, it would look like soft fat on your chest -- not muscle.

Bottom line:  we just don;t have a good answer for you now -- very sorry.

Dr Jacobs

[Paa_Paw]

Unfortunately, you already have the opinion of a man who I greatly respect as an ultimate authority on such matters. I doubt it would be of any value to explore this further. 

[Litlriki]

The problem with implant reconstructions that we currently have to offer is that they provide a static reconstruction in an area that is dynamic.  I have done  a custom implant in a patient with Poland Syndrome, and it worked out fairly well, but that's because he is not as lean as you are, and his soft tissue coverage was adequate to hide the implant.  I have seen another bodybuilder with a partial absence of the pectoralis major, and in his case, I did not feel that an implant reconstruction would work.  It's a very challenging area of reconstruction.

[DrPensler]

Interesting question.Body builders are the most critical and demanding patients. Part of the profile devolves from the type of individual it takes to be successful in the sport and part is due to continual feedback from judges. Basically the athlete needs to continually evaluate him/herself at rest and in a variety of situations identify areas of weakness and improve them. Tissue engineering specifically engineering for innervated functional tissue of multiple types ie nerve,muscle and tendon  is very far away.
Implants are static by nature and look best at rest or to augment essentially normal but underdeveloped muscle. Fat grafts are static and particularly in thin individuals in areas of muscular activity are unpredictable.