Pectus Excavatum Repost. Can I fix this without implants?

Question

I am reposting this question b/c I didn't specify in my last post that the photo(s) are of me and they are not wish pictures. I'm insecure about my pectus , and do not want to get breast implants. I wanted to do fat transfer to the dip/breasts but have heard it's unsuccessful for pectus, I also am very thin so idk where the fat would be taken from. I hate how deep and large the dent looks under my breasts and it makes my ribs stick out. :(

Daniel Barrett, MD · Answer

Dear anonnn..,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It is hard to tell without proper photos and a physical examination. I recommend you to schedule a consultation with a board certified plastic surgeon.

Connie Hiers, MD, FACS · Answer

Just based on your photos, I doubt you have much if any donor fat. However, fat transfer could help minimize the bony defect, but probably not remove it entirely unless a lot of fat were placed or you gained a lot of weight.

Johnson C. Lee, MD · Answer

Pectus Excavatum can be camouflaged to a certain degree with fat grafting or implants. In your case, you do not appear to have enough fat to make a significant difference. Implants can help, however it will not address the flaring of your ribs which is due to the pectus and can only be corrected with the Nuss or similar procedures. You can use larger implants in an effort to make the flare less noticeable. There is also a likelihood that your breasts will appear closer to each other and the nipples may point more inwards due to the pectus and implants will not directly resolve these issues. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon​

Mats Hagstrom, MD (license on probation) · Answer

fat transfer will not be successful for treatment of pectus excavatum. The primary reason for this is the area is completely devoid of proper host tissue to support the graft. This leads to a very high percentage of graft failure.generally in order for fat transfer to be successful someone should not graft more than 100% of the present host tissue.in other words if someone has 1/2 inch of soft tissue between their sternum and their skin you can add 1/2 inch of fat graft.  in your case came out of soft tissue between your skin and your sternum is probably only a few millimeters.the only way to build up significant volume with fat transfer is to do this multiple times grafting small amounts of fat each time.

it's not a correct approach and you should look at other options.realistically for fat transfer to work you would probably need six rounds of fat transfer.

the biggest variable for the success of fat transfer is the presence of healthy host tissue.  there has to be tissue to support the grafted fat in order for the graft to be revascularize to and stay alive.

the ribs flaring under your breasts are not necessarily related to your pectus excavatum.

I suggest having a few in person to consultations with local board certified plastic surgeons in your area.

look for providers who have experience and a proven track record for this procedure.

best,

Mats Hagstrom MD

Linea Nova Body Contouring

Pectus Excavatum Repost. Can I fix this without implants?

Answers (5)

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