Mr Omar Tillo
Consultant Plastic Surgeon
Pectus excavatum treatment corrects the shape of the bone in the middle chest, namely the congenital deformity of the sternum. Pectus excavatum, most commonly known as funnel chest, is a deformity of the thorax that is marked by the median or lateral depression of the sternum. Nearly 1 to 2% percentage of the population is affected by pectus excavatum, being more common in boys than in girls. It is one of the most common types of congenital chest wall abnormality, with an estimated occurrence in between 1 and 300 and 1 and 100000 births.
Thoracic custom-made implants with CAD technology is the solution used for pectus excavatum. At present, it is used as a benchmark procedure at Centre for Surgery because it is easy and reliable. What these implants do is compensate for the congenital deformation. This innovative technique can also help correct breast deformity and asymmetry. Thanks to 3D technology, significant complications are avoided altogether.
These are the long-term results of treatment for pectus excavatum:
Poland Syndrome is a rare anatomic defect caused by a malformation of the homolateral hand and manifests as the absence of the pectoral muscle. This absence can be complete or partial and is most often visible to the naked eye because there is a clear asymmetry at the level of the chest.
Poland Syndrome occurs in men (characterised by a depression under the clavicula) and in women (characterised by a breast asymmetry). Fortunately, this defect can be fixed through surgery. Results are definitive and recovery time is very fast.
Pectus excavatum treatment is reserved for people who are not happy with the way their chest looks and are, thus, concerned with their body image. To be more precise, the surgical procedure addresses young people as well as adults who suffer from psychological discomfort. The treatment equally addresses people who have trouble exercising due to shortness of breath. The heart or lung function is not affected, but there have been peculiar cases.
Anyone who is struggling with Poland Syndrome is encouraged to make an appointment at Centre for Surgery for a consultation. Please keep in mind that the recommended age for this procedure is different for boys and girls. Due to breast development, young women are advised until their chest area is fully developed before they have surgery, while boys can go through the procedure starting at age 13. Although this defect does not cause any health abnormalities or impair movement, it is a major aesthetic concern for people who suffer from it, affecting their self-confidence and body image
Patients like the ones mentioned above make good candidates for chest wall implants. Besides having the desire to improve the appearance of the chest, it is necessary to be in good health. To be more precise, patients should not have major medical problems. Unacceptable patients are those with illnesses that raise the risk of the surgical procedure, like poor nutrition, uncontrolled diabetes, obesity, and disorders of healing.
During your consultation at Centre for Surgery, the thoracic surgeon takes the measurements of your chest and find out what your aims are. Following the visual examination of the chest, the corrective implant to be used is decided upon. The thoracic surgeon measures the extent of the pectus excavatum with the help of a CBCT scan. No healthcare practitioner embarks on a surgery without having a 3D scan of the patient. The 3D scan increases the predictability of the surgical procedure and allows the surgeon to see the interior of the chest. After your body has been scanned, unique implants are made to fit your anatomy.
Treatment for Pectus Excavatum
Many people do not want to undergo pectus excavation surgery, thinking that it is an invasive procedure. You too will be surprised to find out how simple the surgical approach is. Pectus excavation surgery takes place under general anaesthesia and it takes about 1 hour. Surgical repair is an elective procedure, meaning that it requires approval prior to proceeding. The surgeon makes a 7-cm vertical incision across the chest and prepares the locus to the size of the 3D custom-made implant. The implant is introduced in the locus under the muscle, remoulding the bone to a flatter shape. The implant is not visible from the outside. The closing of the surgical procedure is realised in 3 planes with absorbable intradermal sutures.
As with any surgical procedure, there is a specific recovery time. The procedure can be performed as a day case. The surgical procedure is painful only a few hours afterwards. It is expected that you can get out of bed and walk the day following the pectus excavatum surgery. Only a surgical dressing is required for a couple of days and you will have to wear a compression vest for a month. You will be discharged when you are comfortable on pain medication and you are eating and breathing normally. Engaging in sporting activities is not allowed for 3 months following the procedure. You cannot play games or go back to work. You have to get a sick leave for 15 days.
Possible risks and complications
Both Pectus Excavatum and Poland Syndrome surgery is relatively simple and risk-free, but, like in any surgical procedure, complications may occur. Your body will be most sensitive in the couple of days following surgery, but you will under the constant monitoring of a professional. After you get home, there is a certain risk of bleeding and bruising, which is why you should stay with someone who can look after the house for you. The feeling of a full or swollen chest is another common side effect of this procedure, but it can be kept under control with the help of a loose gauze. Make sure you clean and care for the wound, otherwise, you will risk an infection.
Treatment for Poland Syndrome
The average procedure time for Poland Syndrome treatment is one hour, but it can last two hours or more in complex cases when the defect affects an extensive area. The surgery is performed under general anaesthesia and the hospitalisation period is usually three days. During the procedure, the surgeon will fill the missing muscle with a custom implant, made of high tech polymerised silicone. Poland Syndrome treatment typically involves one single surgery, but, if you wish, you can have a follow-up procedure afterwards, where the surgeon can inject your own fat tissue to make the area even fuller.
The ideal age for surgical intervention in patients suffering from pectus excavation is between the ages of 18 and 24. However, surgical correction for chest deformity can be realised on adults too. There is no maximum age when it comes to benefiting from this innovative technique.
The medical practitioner is the one who decides when it is the right time for pectus excavation treatment. Thoracic implants are recommended based on a clinical diagnosis of the surgeon.
After surgery, you have to take good care of your surgical incisions. You can shower every day as long as you wash the incision area gently. Applying a small amount of soap and rinsing is enough. You are not allowed to immerse yourself in the hot tub for at least four weeks. Examine your surgical incisions daily, until they close completely.
Scars will improve over the course of a few days. Surgical incisions heal well, so you do not have to worry about scars.
Your doctor will be the first one you meet during your initial consultation at Centre for Surgery. They will be the same person performing the surgical procedure, looking after you and providing you the care that you need.
Yes, it is. The implant is made of silicone rubber, not gel, and it will not interfere with your body in any way. Also, because no drains are used, the risk of haematoma is also low.
The edges of the implant are invisible and we only use dissolvable stitches, so that scarring is minimal. For a few weeks, the place of the incision will be red and visible, but in time the scarring will fade. If you are concerned about this, you can apply over the counter scar reduction creams to speed up healing.
Yes, you can, but only after three months, otherwise, you risk complications. You can get back to work after 15 days, but even then you should refrain from lifting more than five pounds. After three months, however, if recovery went smoothly and you didn’t have another follow-up surgery for result refinement, you can start working out.
In the first days after surgery, you should wear the special bra provided to you by the clinic. Once your breasts start to heal, you can wear your own bras, but make sure you avoid underwire for six weeks. The area will be quite sensitive and underwire can cause injury.
You will be given a medical leave of 15 days and after that, you can get back to work.
Poland Syndrome is an aesthetic defect that can take a toll on a child’s mental development, especially throughout puberty, when teenagers are already confused by all the changes taking place in their body. Boys can have this surgery done starting at the age of 13, but girls are advised to wait until their breasts fully develop.
The implant will be placed with the patient under general anaesthesia, so you will not feel anything. However, for the following days, the doctor will administer stronger painkillers to reduce local discomfort.