Breast Implant Placement with Pectus Excavatum?

asked 2 years ago by 3boysmom in California
Latest answer by Scott L. Replogle, MD
Question viewed 2,693 times
Tags: pectus excavatum

I am considering breast augmentation and I have pectus excavatum. Is it better to place implants over the muscle or under? I am considering 300cc or less.

12 answers to Breast Implant Placement with Pectus Excavatum?

Pectus excavatum and breast augmentation or enlargement with implants

I have tended to place the implants under the muscle because the breast and skin can be very thin over the pectus and can make the implants more visible with a higher chance of rippling. However, I also inform my patients that the implants tend to slide towards the middle of the chest creating very pronounced cleavage with nipples that tend to face inward (cross-eyed appearance). I have a video below which demonstrates 3 varying cases of pectus excavatum breast augmentation with implants.... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Breast augmentation and pectus excavatum

Patients with pectus excavatum do very well with breast augmentation. You can have the implant placed either under or above the muscle based on your own tissue characteristics and preferences. Having the implants placed under the muscle has many advantages and will give you a good result. The only caveat is having too large of an implant placed and/or violating the space separating the breasts which can lead to symmastia or "one breast". Make sure you discuss all your concerns... more

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Breast implants with pectus excavatum

It has been my experience that performing a breast augmentation in a woman with pectus excavatum can be performed with under the muscle coverage, yielding a good result. Each patient musct be evaluatied independently and properly consented. There is a little higher risk of symmastia, and classically, the breasts are closer together after surgery. It is best to show a patient pictures of a similar patient so that they can know what to expect. It is also very important to choose the proper... more

Michael C. Edwards, MD
Las Vegas Plastic Surgeon

www.medwardsmd.com

Breast augmentation, pectus excavatum

In patients with pectus excavatum (concave chest wall) subpectoral placement of breast implants can give a nice result. The implants can not be too large in size or they could end up too close and create a very unnatural appearance to the breast and cleavage. A modest implant of 300cc or less may be a reasonable implant selection. Discuss this further with your board certified plastic surgeon prior to surgery. Best wishes, Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon

Breast augmentation in pectus excavatum

Hello 3boysmom My experience with pectus excavatum is very similar to what Dr. Rand describes and I completely agree with his assessment. In our Santa Rosa practice we do submuscular breast augmentation for patients with pectus excavatum and we are careful not to bring those implants to close together as they do have a tendency to fall into the midline. Make sure your surgeon is experienced in patients with pectus and ask to see before and after photos of appropriate patients. Best of luck. more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

Breast augmentation with pectus excavatum

Because the patient with pectus excavatum has a deeper midline, they will generate much more cleavage faster than one with a flat chest wall. Also, the implants will sit on a bony platform that will encourage them to tumble to the center risking a "uni-breast" deformity. Consequently, the experienced surgeon will use a slightly smaller implant and will go under the muscle and make sure to leave enough tissue intact along the midline to prevent the implants from coming too close. ... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast augmentation with pectus excavatum

Pectus excavatum, like asymmetry, makes it even more necessary to be precise in implant size selection and placement. The size of the implant is best determined by the width of the breast and the forward profile chosen, not by cc's of volume first. The more forward the profile of the implant, the more the cleavage concavity will be accentuated. The implant must be sub-pectoral from years of experience both short and long term. Sub-glandular placement will almost certainly result in an... more

Scott L. Replogle, MD
Denver Plastic Surgeon

Pectus excavatum and breast implants

Pectus excavatum can cause problems with implant placement. It will not improve the excavatum. It actually may accentuate it. You need a very thorough exam.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast augmentation for pectus excavatum

It's difficult to determine the best position of the implants without actually seeing a photo of your chest. If the pectus is severe you may want to get this fixed before embarking on an augmentation. If not, over or under the muscle should be okay. Talk with your plastic surgeon about the pros and cons of over or under the muscle, and check out some before and after photos to determine the look and size that you want. Good luck!

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

www.BaltimorePlasticSurgery.com

Breast implants in patients with Pectus Excavatum

Hi there- You should be able to achieve a very nice outcome from breast augmentation whether your implants are placed above or below your chest muscle- My personal opinion is that there are a great many advantages to sub-pectoral (under the muscle) placement, but existence of a pectus excavatum would not affect these. I would find a surgeon certified by The American Board of Plastic Surgery who has a lot of experience in breast surgery- ask if they have patients with pectus excavatum you... more

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Pectus excavatum

Being better or worse depends on what you are measuring: is it cleavage, is it risk of capsular contracture, is it naturalness? You should go over all the variables that are important to you in your situation. 300cc implants are not specific enough to judge end result since implants with the same volume can have different characteristics and dimensions, and the same size implant will look diffeent depending on what you start with. I would suggest going over your concerns and options with... more