Patients with pectus excavatum have a chest pattern opposite to that of patients with pectus carinatum. Pectus excavatum is also a congenital chest deformity. Patients have the following characteristics:
- Disc-shaped concavity at the center of the sternum; prominent ribs
- Abnormally thin midline skin
- Minimal breast development (completely flat chested)
- Usually complicated by asymmetry in breast size or height
Patients with pectus excavatum usually have a smaller frame and incomplete or no breast development because of the compressed lung space resulting from a congenitally concave chest. Scoliosis or problems such as uneven breast and nipple height are often observed along with pectus excavatum. Therefore, a careful preoperative evaluation is essential to ascertain whether these patients’ health conditions are suitable for breast augmentation. If patients only have a concave sternum rather than problems such as oppressed cardiovascular functions, regular breast augmentation procedures can be used to improve breast appearance and hide the deformity. The following are special considerations about this approach:
- These patients normally have thin chest skin. Hence, silicone gel implants are preferred because they take into account both natural look and touch.
- Submuscular placement of implants is preferred to reduce wrinkling or rippling at the midline.
- The two pockets at the midline should not be too close to avoid the breasts from being too concentrated or subject to symmastia in the future.