Pectus excavatum repair from a plastic surgeon’s perspective

Abstract

Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed. However, any secondary re-do MIRPE procedure remains risky because of adhesions between the pleura, lung, pericardium, thoracic wall as residuals from the primary intervention.

The changes of distance between nipples following correction of women pectus excavatum

“…Schwabegger et al named the symptom that normally developed breasts in puberty 20 were slanting medially along the slope of distorted ribs in women pectus excavatum patients as breast strabismus 21 – 23 . These breast deformities like breast strabismus cause emotional distress in female pectus excuvatum patients, even though a functional issue with breast strabismus has not been known.…”

Application of preshaping technique in Wung procedure of severe asymmetric pectus excavatum

“…The outstanding structural feature of pectus excavatum is the depression of anterior chest wall, and the purpose of surgery is to eliminate the depression. In the early years, the surgery was open operation [6] , and the representative operations were Ravitch procedure and sternum turnover operation. These operations had their advantages, but the damage was large and the postoperative scar was long, so they were not ideal choices.…”

The changes of distance between nipples following correction of women pectus excavatum

“…Schwabegger et al named the symptom that normally developed breasts in puberty 20 were slanting medially along the slope of distorted ribs in women pectus excavatum patients as breast strabismus [21][22][23] . By remodeling the anterior thoracic wall with Nuss procedure, the slaning breasts were relocated to their orthotopic position, resulting in a more naturally breast projection 23 .…”