Pectus Excavatum and Pec Implants

Question

I am 37 year old male with pectus excavatum. It was described by a pedatric surgeon that I have a 'grand canyon' appearance with slightly flared ribs. I can provide digital pictures. I was told I am not a candidate of nuss procedure and I think it wold be too painful over implants. I am trying to go for a symmetrical appearance. Its noticeable with shirt on or off. Can I expect a good outcome? Also, how will implants affect my running (I do 5k, half and full marathons)?

Sam Gershenbaum, DO · Answer

As previously stated, Pectoral Implants would tend to accentuate  the mid sternal depression or defect of the pectus excavatum. It sounds like a custom sternal implant would be the most suitable correction, if a surgical correction of the bony sternum is out of the question. In doing the silicone custom implant for the pectus excavatum defect, it is very important to secure the implant to the sternum to prevent the implant from moving or slipping down into the skin creating a visable and palpable edge of the implant. I generally treat smaller pectus excavatum defects with fat grafting, which may require more than one treatment.

Gregory Turowski, MD, PhD, FACS · Answer

Hello,without seeing your pictures or even better examine you in person it is hard to decide what is your best option. But given your description it sounds like you might be a good candidate for a custom chest implant. Pectoral implants could be an option but generally they will not help with pectus excavatum. Custom implants are designed to fit your particular defect snugly. The other option could be a fat transfer

Rikesh T. Parikh, MD, FACS · Answer

Hello, depending on your case a custom sternal implant to fill the depression or possibly different pec implants. Fat transfer for smaller depressions if present. After examination by a plastic surgeon your option will be discussed. Thanks for your question.

Marc DuPéré, MD · Answer

Thank you for your question and YES, body implants could be a solution to your condition.I have done over 200 pectoral augmentation over the last 7-8 years. I have also treated several patients with pectus excavatum in Toronto since 2001. A pectus excavatum is a body depression in the mid-chest that can be symmetrical or asymmetrical. The options will vary on what I see at the time of the consultation with you.I have done #fatgrafting with #stemcells in some patients for very small defects.Other, we fabricated a custom-made implants; patient comes to the office and we prepare a mould of the defect, which is then sent for fabrication, then sterilized then shipped back to Toronto for implantation. This involves a few visits to #Toronto, Canada.The other options might be unilateral or bilateral pectoral augmentation with implants, either same implants or different sized implants depending again on your anatomy.Sometimes, fat grafting is also part of the pectoral implant procedure.Perfect symmetry is rarely achieved in plastic surgery yet we can get very close to it. Once fully recovered, patients can return to cardio-vascular physical activity in 2 months and body-builder activities in 3 months.Good luck in your search and make sure you choose an experienced surgeon as this is not a common procedure learned in plastic surgery residency.Should you want to come to Toronto, we do offer SKYPE-cam consultation as a first encounter. Email us some pics.

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Dr. Marc
DuPere, Toronto plastic surgeon

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plastic surgery Clinic in Toronto for 2013 and 2014

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Best
regards,

Dr. Marc
DuPere, Toronto plastic surgeon

Voted TOP
plastic surgery Clinic in Toronto for 2013 and 2014

Voted TOP
Cosmetic Clinic in Toronto for 2014

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Kenneth Hughes, MD · Answer

Implants over the sternum may be a viable option for a larger defect.  Fat grafting can be helpful in smaller defects or in camouflaging the implant.Kenneth Hughes, MDLos Angeles, CA

Tom J. Pousti, MD · Answer

It sounds like you might need a custom implant to help camouflage the depression around the midsection of your chest wall.  I have done this procedure for many patients with similar situations and they are happy. Every surgery has potential risks and complications (this one does as well) so find a surgeon who has performed this surgery and who can give you honest advice.

Barry L. Eppley, MD, DMD · Answer

Pectus excavatum is a central sternal deformity, at its deepest, and it tapers out to the sides of the rib cage. Pectoral implants enhance the pectoralis muscle which is not located over the sternum. Building up the outline of the pectoral muscles is likely to make the pectus excavatum deformity look worse as it does not improve the sternal area. You should consider other implant options that can be used directly over the depressed sternum.

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