Patients with pectus carinatum are characterized by a protruded sternum that is like a pigeon’s chest. It is a type of congenital sternal deformity.

Patients have the following characteristics:

Abnormally splayed breasts and nipples
Thin and tight chest skin
Obvious protrusion of the sternum and ribs in the center of the chest (bone process)

front image of a splayed breast

Patients with pectus carinatum have abnormally tight chest skin because of a protruding sternum. Therefore, skin thickness and elasticity should be considered when choosing between submuscular and subfascial placement. A single procedure is not suitable for all patients. The following are special considerations in the technique of breast implants:

The size and diameter of implants should be larger than that in usual procedures to overcome problems such as more apparent breast splay or more distant nipples.
The medial pocket should be made as close to the midline as possible to create a concentrated and fuller visual effect and achieve the goal of fixing the protruding sternum.
Silicone implants should be used to avoid rippling or wrinkling near the midline.

Surgical conditions

Duration

0.5hr

Type of anesthesia: General anesthesia
Type of incision: Transaxillary or periareolar incision
Recovery: Within 3 days
Removal of stitches: 7–10 days

General instructions

No food and water on the day of surgery

0hr

Frequent stretching should be performed for 1 month postoperatively to prevent axillary scar adhesion.
Tasks and exercises that require excessive arm strength should be avoided, and underwired or push-up bras should not be worn for 3 months postoperatively.
Smoking and consumption of collagen or vitamin C should be avoided for 3 months postoperatively to prevent the formation of capsules.
Consistent and regular breast massage should be performed for 6 months postoperatively to maintain breast shape and softness.

Possible complications

Capsular contracture
Splayed breasts
Less concentrated cleavage
Scar adhesion (underarms)
Implant edges or wrinkles noticeable on touch
Insensitive or oversensitive nipples (temporary)
Implant leakage or rupture

Surgical advantages

Implants can hide the protrusion of the sternum and ribs and restore the normal appearance of the breasts.
The procedure can both increase breast size and correct sternal deformities.
The procedure can fix splayed breasts or nipples.

Surgical drawbacks

Implant size should be increased depending on the severity of pectus carinatum, thus limiting the flexibility of breast sizes.
Implant edges or wrinkles might be palpable in those with thin chest skin.
Splayed breasts may not be completely corrected.
Improper postoperative massage could result in less centered breasts and cleavage.