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