Breast Implant Placement with Pectus Excavatum?

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. Please forward to 1min 30 secs.

Of course, breast implantation placed subpectorally can very effectively mask many of the chest wall deformities with pectus excavatum unless it is severe.

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!

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 might be able to talk to, and ask to see photos.
Good luck!

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

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  initially presented with pectus excavatum.  I usually recommend under the muscle for longer term results as well as reduction in potential for rippling and palpability of the breast implants.  Each patient is different so it will be best to have an examination.

 

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.

I would suggest that you meet with well experienced board-certified plastic surgeons;  asked to see lots of examples of his/her work.

Best wishes.

 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.

Hi,
I agree with the other posts that the implants can be placed above or below the muscle. I prefer sub-muscular implants because the muscle coverage prevents rippling from being noticeable especially in thin individuals. The size sounds about right for you and should not be too large.
In my experienc,e the implants improve the appearance of the pectus in that the indented area of the chest wall is less noticeable.

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 with your surgeon.

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 sized implant and to not go too large. I recommend you discuss your concerns with the board-certified
plastic surgeon
you choose. I wish you well.
Dr Edwards