Pectus excavatum, also known as a sunken chest, is a common congenital chest wall deformity in which the sternum and ribs are pushed inward. This creates a concave appearance to the chest. It occurs more frequently in men but can also occur in women. Because of the presence of breasts in women, or the lack thereof, the desire for breast augmentation may be requested. With a sunken chest the question is how well do breast implants work in females with such chest wall deformities and do they make aesthetic and psychosocial improvement,
In the June 2024 issue of the journal Plastic and Reconstructive Surgery Global Open an article was published on this topic entitled ‘Can a Breast Augmentation Procedure Improve the Appearance of Pectus Excavatum Deformity in Female Patients? A Prospective Study. Over a four year period twenty-eight (28) females with pectus excavatum were treated with silicone breast implants placed in the dual plane submuscular position. Their quality of life regarding their chest wall deformity was assessed using a Single Step Questionnaire. (SSQ) They were also assessed at initial screening and 24 months postop using the BREAST-Q V2 questionnaire to determine quality of life and psychosocial well being from the surgery. A pain-evaluating questionnaire evaluating the first 5 days after surgery to determine the recovery was also used.
Their results showed that there were no surgical complications. The SSQ questionnaire showed a high satisfaction rate and significant improvement after the surgery. The BREAST questionnaire showed improvements in psychosocial well being and satisfaction were equally high. The pain was minimal during the first five days after the surgery.
Breast implants in this study of women with pectus excavatum were associated with high satisfaction rates with no increase in complications. To some degree this is no surprise given that the submuscular plane for implant placement is still available for use. What is of greater interest is how do breast implant look in the sunken chest…does it make the sunken chest look worse or better? In my experience in mild pectus excavatum the deformity actually looks less obvious. In more significant pectus excavatum the depth of the sternum does look deeper but as this study demonstrates the patient still feels better about their overall chest appearance.
Dr. Barry Eppley
World-Renowned Plastic Surgeon