Fat Transfer for Slight Pectus Excavatum?

I don’t think that you can improve the pectus excavatum sufficiently with any filler as there would be too much volume needed to make the contour flush with the surrounding skin. Fat cells would die in the center of the implant secondary to a lack of oxygen diffusion traveling through the mass of the fat injection. Too much filler could compromise the skin’s circulation above the implant and the skin could ulcerate causing a bad scar. Contour improvement is accomplished by plastic surgeons who perform significant foundation changes on the bone structure. I would suggest you consult with such a plastic surgeon who does thoracic surgery and ask them about performing an implant versus surgery.

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Fat grafting is a valuable tool in breast surgery. This technique has gained more popularity
over the past 7 years. There are many
techniques used to harvest the fat, process the fat and then re-inject the fat.
Conventional suction lipectomy is performed with a small diameter cannula,
processed by separating the liquid and fibrous tissue from the fat, and then
placed into syringes for re-injection or through a closed system.

A key principle in Plastic Surgery is to replace tissue with similar tissue whenever possible.
The procedure Dr Kasden refers to has the advantage of using your own ribs and sternum, but as he says, it is long and can be risky. It is for me too much of a run for a short slide.
Fat grafts are possible, and I do a lot of fat grafting, but the tissue is soft, and the effect would be weird in an area which is usually firm to the touch.
Breast Implants can camouflage the defect.
The best solution, in my opinion, is a custom molded implant. In my experience, this gives the best result, and the best "feel" of a normal chest wall.