Classically, it consists of a combination of unilateral aplasia of the sternocostal portion of the pectoralis major muscle (PMM) and hypoplasia of the ipsilateral hand, with syndactyly and synbrachydactyly.
First Degree (Mild): The diagnosis of first-degree PS would be made in a patient with mammary asymmetry caused by hypomastia or amastia and areolar asymmetry, with or without a partial absence of the pectoralis major muscle (PMM). No other musculoskeletal alterations are observed; other congenital alterations may or may not be present.Second Degree (Severe): Hypomastia or amastia, areolar asymmetry, total absence of the PMM, and alterations of the ipsilateral muscle group and/or bones of the chest results in a diagnosis of second-degree PS; ipsilateral superior limb alteration and other congenital alterations may or may not be present.Third Degree (Very Severe): Third-degree PS would be diagnoses in patients with amastia; areolar asymmetry; major ipsilateral musculoskeletal chest alterations, such as total absence of the PMM, the pectoralis minor muscle, and /or the serratus anterior muscle; possible lung herniation; widened opening of the mediastinum; and ipsilateral superior limb alteration. Other congenital alterations may or may not be present.
First Degree (mild) – Breast implantation or customized breast implantation and contralateral mammary reduction or augmentation when needed (symmetrization procedure).Second Degree (severe) – Tissue expander placement when needed; regional local flap surgery; breast implantation or customized breast implantation; symmetrization procedure.Third Degree (very severe) – Tissue expander placement; latissimus dorsi flap or other flap surgery, such as a free flap or transverse rectus abdominis myocutaneous (TRAM) flap; breast implantation or customized breast implantation as needed; other surgeries such as the Ravitch procedure and a contralateral symmetrization procedure.