Pectus Excavatum Correction
Pectus excavatum is a common deformity that typically presents as a “divot,” “depression,” or “concavity” in the chest wall or chest bone, with or without the involvement of the ribs. Pectus excavatum can vary in severity and is typically a congenital condition, which means it is present at birth. Pectus excavatum is often asymmetric in presentation. Dr. Marc DuPéré offers pectus excavatum surgery in Toronto for men and women who feel self-conscious about this condition, especially when it comes to removing their shirts at the gym, pool, or beach.
How Can Pectus Excavatum Correction Help?
Pectus excavatum is a deformity in the chest wall. It begins to form while the fetus is still developing. The chest wall becomes too deep, resulting in a visible divot, crater, or dent in the chest. Mild cases of pectus excavatum don’t typically cause any sort of physical symptoms, but severe cases can result in chronic fatigue, exercise intolerance, or breathing difficulties. Many surgical treatments exist for treating severe cases where respiration is affected. These are typically performed when the patient is young. One such procedure is called the NUSS procedure, wherein metal bars are inserted under the chest bone. For all other cases of pectus excavatum where the issues are more cosmetic, Dr.DuPéré offers a specific, customized treatment. This is also indicated in cases of an unsuccessful NUSS procedure.
Dr. DuPéré’s Pectus Excavatum Correction Techniques
Dr. DuPéré’s technique for treating pectus excavatum completely depends on the patient’s specific needs. The most common treatment options include the following:
After Custom Implant
- Custom implant: As the most common option for treating pectus excavatum, this technique uses a custom implant that’s been designed to specifically fit the patient. The procedure requires an initial pre-op visit to make a mould of the sunken area. Dr. DuPéré makes the mould, and the patient’s input with regards to shape and input is encouraged. The mould is then sent to a medical device manufacturer where the implant is manufactured, sterilized, and packaged before being sent to Toronto. The implantation procedure is most often performed while the patient is fully anesthetized, but smaller implants may be placed while the patient is under deep, intravenous sedation. Dr. DuPéré makes an incision where the chest bone meets the lower ribs and places the implant over periosteum and under the fascia. Because the implant has been made to match the patient’s unique anatomy, the result of this approach often looks completely natural. Patients can subsequently continue to grow and develop their pectoral and abdominal muscles as before.
Read Dr. Dupree’s Blog Post: “A Story of Pectus”
- Pectoral augmentation: Pectus excavatum correction can occasionally be achieved through the use of prefabricated pectoral implants. These soft but solid silicone implants are different from breast implants because they are solid and and designed to feel like natural muscle. The pectoral implants are placed beneath the original muscles via a small underarm incision, and the patients can continue to grow their pec muscles afterward. This approach is best for patients with more mild cases.
- Fat grafting: This popular technique uses liposuction to remove fat from one area of the body to augment another area, especially the buttocks, hips, breasts, lips, and cheeks. During a pectus excavatum correction surgery, Dr. DuPéré uses a less invasive form of liposuction to remove the fat, which he then purifies and adds to the chest. He carefully fills in the divot layer by layer to achieve a smooth, attractive result. Because fat grafting requires a thick, vascularized recipient area to ensure the fat cells survive, patients with serious pectus excavatum are usually not ideal candidates for this option unless the defect is mild. Fat grafting can, however, be used to smooth down the implant edges in thin patients.
Risks & Complications
Specific risks of pectus excavatum correction depend on the technique used, although the procedure is no riskier than any other type of surgery. Patients must be mindful of the possibility of infection, excessive swelling, or implant malposition. However, these complications are rare, especially when the surgery is administered by a professional such as Dr. DuPéré. During a personal consultation with your surgeon, the doctor will provide you with specific guidelines about what you can expect before, during, and after your procedure.Back to Top