What Can I Expect From Augmentation For A Concave Chest?

Im 5'10 and 125 lbs... An A cup right now want to achieve a C cup. My surgeon recommends 304cc of silicone and discussed my concave chest and if i go to big the implants would come together. What size can I expect with 304 cc and would they still look natural on my little frame?

Update 1/10/12- photos added

Doctor Answers 10

Pectus Excavatum and Breast Augmentation?

Thank you for the question.

If you have pectus excavatum ( concavity in the sternal area),  then breast augmentation may be helpful.  In my experience, breast implants tend to help “camouflage” the concavity,  making the cleavage area look deeper. Often times postoperatively is hard to know that the patient presented with pectus excavatum.

Often, patients with pectus excavatum have medially sloped chest walls ( sloped towards the cleavage area);  care must be taken during the breast implant pocket dissection to avoid the implants coming together too close in the sternal area.

Also, patients with pectus excavatum may have their nipple/areola complexes relatively medially positioned on their breasts;  without intervention this inward  leaning appearance of the nipple/areola does not improve with breast augmentation surgery.

Some information about pectus excavatum ( men and women) may be helpful…

Pectus Excavatum, also known as cobbler’s chest, sunken chest, funnel chest or simply a dent in the chest, is the most common congenital chest wall deformity, in which several ribs and the sternum grow abnormally. This produces a caved-in or sunken appearance of the anterior chest wall. Typically present at birth, this condition continues during the time of rapid bone growth and worsens until early teenage years. The severity of the defect and asymmetry of the chest widely vary. Pectus excavatum is often considered to be cosmetic, however it can impair cardiac and respiratory function, causing pain in the chest and back. People with the abnormality may experience negative psychosocial effects, and avoid activities that expose the chest.

For male patients, I have found that custom made solid pectoral implants made specifically for the area of depression is an option for a better cosmetic result. Pectoralis implants can be used to augment the male chest wall. Implants can be used to provide additional projection of the chest wall enhancing the appearance and often times self image of the patient. In order to meet the needs of the specific patient, I meet with the patient to make the moulage for the custom silicone implant.

This preparation can take up to 1-2 hours to make and dry. The moulage is then sent to the company so that a solid silicone implant can be made from it to fit the patient. The specifics of the operation vary from patient to patient. During the consultation with the patient, I discuss the amount of augmentation that the patient desires. The preferred shape of the chest wall is also discussed with the patient. Pectoralis implants have been very successful in allowing the patients to achieve increased fullness in the chest area.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Breast augmentation with a concave chest

Augmentation results depend on the base upon which the implants will rest.  If you have a bony deformity such as a central concavity (pectus excavatum) choosing the right implant size is critical.  As you suggest, implants that are too big will give an abnormally crowded cleavage.  Conversely, implants that are the right size can help mask a central depression.  Asymmetry may also be a problem since some concavities are asymmetric.  

Give your surgeon the leeway to try different sizes in the OR and then to choose the right implant size based on what is seen during surgery.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 46 reviews

Pectus excavatum

Breast implants may camouflage smaller concave chest (pectus excavatum) but if the pectus concavity is large breast implants alone will certainly not make the chest look normal.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Augmentation with a concave chest

Breast augmentation with a 'concave chest' is a special challenge because as the breast projection and size are increased, the relative concavity can appear deeper. With a projecting implant you will not have the implants come together, rather you see a canyon effect between your breasts. A very moderate profile implant will be beast, gel is fine, and the 304cc might be OK but we don't know enough to tell.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Contact your PS

Thank you for the question. It would be difficult to fully assess your situation without an in-person examination.  Large implants could be able to "camouflage" your concave chest but hard to say if it will still look normal. Bring up all your concerns with your board-certified plastic surgeons. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 95 reviews

Breast augmentations aren't always as simple as they seem...

This type of question really reinforces the reasons to only see an experienced, board certified plastic surgeon when considering this types of procedures. Even a procedure like a breast augmentation can be more complicated than it appears, as in the case of a patient will a concave chest. Only good rapport between the surgeon and patient can maximize the chances for a great surgical result.  Although the photos you posted are helpful to give a general answer, these things really need to be discussed in person with your operating surgeon. Good luck to you!


William Franckle, MD, FACS
Voorhees Plastic Surgeon
4.9 out of 5 stars 32 reviews

Breast Implants for Concave Chest

A concave chest or pectus excavatum is not that uncommon.  Many patients with a pectus can benefit from simply placing breast implants. The breast implants actually help hide the indentation of the breast bone.   The main concern is not to make the implant pocket too close to the midline of the breast bone, so as not to end up with a "uniboob" or synmastia.  The differences from one side to the other will remain after your surgery, but the volume difference can be improved.  I commonly make the incision in the armpit to avoid a "cut" on the breast. Also be aware you will never  obtain cleavage because of the indent and the high risk of migration of the implants toward the center on the breast bone.  All the best, "Dr. Joe"

Joe Gryskiewicz, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 276 reviews

Breast augmentation for a concave chest

Thank you for your question and the pictures. Appropriate selection of the right implants which are then well-placed under the breasts can do an excellent job of camouflaging a concave chest. See two or more board-certified plastic surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Implants and concave chest

it is difficult to predict the final cup size but you might get to a small "C" cup.  The concavity will stay because that is specifically a bony anatomy issue.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Concave Chest Augmentation

Without pictures, it is difficult to determine what you will look like or what size a certain implant will make you.  If you have a very narrow width ribcage, larger implant diameters can create problems.  I would make sure you see a board-certified plastic surgeon, and possibly get several opinions before deciding. Good Luck

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 73 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.