We present a new approach to the old problem of congenital chest wall malformation--an approach that is anatomically reliable, physiologically sound, and cosmetically pleasing. The procedure used the patient's own tissues, thus avoiding the problem associated with the use of a foreign body, such as a silicone mammary implant. In addition, no loss of muscle mass is seen due to the retention of the normal neurovascular supply to the latissimus dorsi muscle.