Congenital Breast, Gynecomastia, and Chest Wall Deformities — Anatomy, Diagnosis, and Surgical Strategy

This episode reviews the core principles of congenital breast deformities, gynecomastia, and chest wall reconstruction, focusing on embryology, anatomy, diagnosis, and operative strategy.Topics include the mammary ridge, polythelia, polymastia, amastia, amazia, and athelia, with emphasis on recognizing ectopic breast tissue and protecting the developing breast bud in children. The episode also reviews breast vascular anatomy, including the internal mammary, lateral thoracic, and thoracoacromial systems, as well as key nerves such as the fourth intercostal nerve, long thoracic nerve, and thoracodorsal nerve.Congenital and developmental deformities are discussed, including Poland syndrome, tuberous breast deformity, symmastia, and the surgical principles used to correct each condition. Techniques include latissimus flap reconstruction, tissue expansion, implant-based reconstruction, radial scoring, lowering the inframammary fold, dual-plane pockets, donut mastopexy, and capsulorrhaphy.Gynecomastia is reviewed through diagnosis, classification, and management, including true vs pseudogynecomastia, neonatal, pubertal, and senile patterns, medication and tumor workup, Simon classification, liposuction, gland excision, the Webster incision, pull-through technique, free nipple grafting, and prevention of the saucer deformity. Additional topics include Mondor disease, hematoma, double bubble deformity, and tissue-based implant planning using the High Five principles.Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons.DisclaimerThis podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.SEO / Topic Keywordscongenital breast deformities, breast embryology, mammary ridge, polythelia, polymastia, amastia, amazia, athelia, ectopic breast tissue, Poland syndrome, tuberous breast deformity, constricted breast, symmastia, gynecomastia, true gynecomastia, pseudogynecomastia, Simon classification, Webster incision, saucer deformity, Mondor disease, internal mammary artery, fourth intercostal nerve, High Five breast surgery