Intentional Lower Pole Rotation of Anatomic Breast Implants in Chest Wall Deformities

Abstract

Several methods have been described for the correction of congenital thoracic wall deformities. Our aim was to investigate the feasibility and clinical results of using standard anatomic breast implants with modified anatomic positioning according to the defect in congenital thoracic wall deformities. Between 2014 and 2015, 5 patients diagnosed with pectus excavatum (PE, n = 4) or pectus carinatum (PC, n = 1) and breast asymmetry or hypoplasia were evaluated. In all patients, a submammary incision and dual-plane subpectoral placement of texturized, anatomic implants were performed. In patients with PE, the lower pole of the implant was positioned medially to compensate for the caved chest. In patients with PC, the lower pole of the anatomic implant was positioned laterally to compensate for the prominent sternum. Outcome measures were satisfaction, minor and major complications, and morbidity. The mean surgery time was 95 ± 14 minutes, and the mean implant volume was 287 ± 56 cm³ (273 ± 60 cm³ on the right side and 305 ± 60 cm³ on the left side). After a median follow-up of 25 months (range: 2-35), all patients healed uneventfully, and a satisfactory correction of the thoracic wall deformity was achieved. Thus, by adjusting the lower pole of anatomic breast implants in a horizontal plane according to the thoracic defect, we showed satisfactory results. Our technique has a low complication rate and can be recommended for the correction of mild to moderate PE or PC.

Fig. 1.

A 23-year-old patient presenting with PE and breast asymmetry (A and B). Anatomic implants (345 cm³, medium height, high projection on the right side and 215 cm³, medium height, moderate projection on the left side) were inserted in a dual-plane subpectoral pocket. After a follow-up of 7 months (C and D), a symmetric and aesthetic pleasant result was achieved.