Chest reconstruction for Polands syndrome


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This patient is a male who has Poland syndrome. He had a previous reconstruction using an implant, however, the implant did not sit adequately and therefore does not look realistic enough. He comes in this time for replacement of that implant with another one. He also has fullness in the lateral aspect of the right chest and wishes to have some liposuction in this area to improve the contour.

After consent was obtained from the patient, he was taken to the operating room and placed in a supine position. After induction of adequate general anesthesia, chest was prepped and draped in usual sterile manner. I made a small incision at the site of the previous scar and infiltrated the lateral flank tissue with modified flank position. I used 340 cc. I then used the same incision to aspirate the fat from the area involved and obtained 300 cc of aspirate. After doing so, the incision was then elongated. I excised the previous scar. I then entered the cavity where the implant had been in place and removed it. I placed the new implant, but it seemed a little too large in terms of its width. I then opened the pocket laterally in small amount to allow for this to fit adequately. I then closed the wound with 3-0 Vicryl suture followed by 4-0 running subcuticular Monocryl. Mastisol and Steri-Strips were applied. The patient tolerated the procedure without difficulty and was taken to the recovery area in stable condition.

Would you just use 19380 or can you bill the lipo with it?

Thanks for your help!