- read about pectus excavatum surgery
- see before and after photos-videos
- alternatives, risks, benefits & recovery
Pectus Excavatum – funnel chest or depressed sternum is usually noted after birth but in some people it is not visible until they are older as the deformity can be unpredictably progressive. The exact cause is not known but it is more common in males than females. It is believed to be due to overgrowth of the rib cartilage adjacent to the breastbone (sternum) which pushes the breastbone backwards. Most people have no symptoms but if the breastbone is pushed back far enough heart & lung function can be compromised.
Because of the great variablity of this congenital deformity among those who have it a custom made implant must be used. A plaster model is made of the deformity in the plastic surgeon’s office. The model is then sent to the manufacturer who makes a custom silicone implant. The implant is then surgically inserted to camouflage the condition.
Note that the abdomen appears to protrude due to the chest depression. After placement of the implant it appears to protrude less even though its position has not changed. The first picture after surgery (top right) is about a month after. The second (bottom left) was taken about a year after surgery and shows the additional benefit of an exercise program after surgery as well as the self confidence patients develop after successful correction of this problem. The last photo (bottom right) was taken 11 years after implant surgery without any additional surgery. This proves that the results are long lasting.
This patient had previous chest bone surgery that did not correct the pectus excavatum sufficiently. Dr. Stone placed the custom implant through the original bone surgery incision.
Video: Pectus Excavatum
Pectus excavatum – funnel chest surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.
Bone adjusting surgery is the only available reliable alternative to implant camouflage surgery. Many patients do not get sufficient correction of the concavity with bone surgery but bone surgery definitely improves lung and heart function if they are impaired by the pressure of the bone. If the Haller index on CT scan is more than 3.2 or 3.5 most health insurance companies will pay for the one surgery. They will not cover the implant surgery because it does not improve function.
As with any type of surgery there is the risk of infection or bleeding. Additionally there is the risk of seroma or blood fluid collections around the implant, shifting of the implant out of position, visible or palpable implant edges, visible scar where the implant is inserted, numbness or tingling sensations of the nipple complex. If a fluid or blood collection appears it can adversely affect the skin surface contour.
The risks are more likely if the implant is placed under the chest pectoralis major muscles and on top of the rib cage but this yields a vastly superior result to an implant placed on top of the muscle and just under the skin. The second more superficial drain is required because the drain under the implant cannot access that space. To minimize the risk of fluid or blood collecting around the implant Tisseel tissue glue is sprayed on the front and back walls of the implant pocket and drains are placed behind the implant and on top of the muscle.
The benefits are not being self conscious when in a bathing suit at the beach, not having to wear layered loose clothes to hide your condition and not hiding in the gym locker room. Being pleased with your new appearance can be a major incentive to changing your lifestyle, diet and exercise regularity in order to maintain your new look. Some patients report they have never been to the beach or a gym before surgery because they were self conscious of their appearance.
All patients stay in an after care facility for 1 night after surgery. Skin sutures are removed at 10 to 12 days. The drains stay in place usually for 4 to 6 weeks and activity restrictions are best followed for 8 weeks. A gradual return to before surgery exercise routines is then advised. Without the tissue glue the drains may have to stay in place for up to 12 weeks.
Dr. Aaron Stone
Call today for a consultation!120 South Spalding Dr, Suite 330
Beverly Hills, Los Angeles,CA 90212