Surgical Treatment

Surgical treatment is typically reserved for those with a more severe case of Pectus Excavatum, since the physiological effect on the heart and lungs necessitates treatment to prevent further negative medical consequences. However, due to its effect on the cosmetic appearance of the chest, and the resulting negative psychological symptoms, many individuals with a less severe case of the condition also opt to undergo cosmetic surgery to remove the abnormality, thereby getting rid of the negative psychological symptoms. To read some first hand experiences of individuals who have undergone surgical treatment, please visit the blog.

There are a number of different surgical options available to those with Pectus Excavatum which are detailed below:

  • Nuss Procedure
  • Ravitch Technique
  • Chest Implants
  • Dermal Filler
  • Magnetic Mini-Mover Procedure

Nuss Procedure

The Nuss procedure was first developed by Dr. Donald Nuss, based at Children’s Hospital of The King’s Daughters in Norfolk, Virginia. The Nuss technique is minimally invasive. It involves inserting one or more concave steel bars into the chest, underneath the sternum, through incisions made at the side of the chest. The bar is rotated to a convex position which pushes the sternum outwards, correcting the in-ward appearance of the chest. The bar usually stays in the body for roughly two years, although many surgeons opt to leave the bar in for a longer period, up to five years. When the bones have solidified into place, the bar is removed through outpatient surgery. As a result the patient is then permanently cured of the deformity.

Ravitch Technique

The Ravitch technique is a highly invasive surgery that was developed in the 1950s to treat the condition. The procedure involves creating an incision along the chest so that the cartilage can removed and the sternum detached from the ribs. A small bar is subsequently placed underneath the sternum to hold it up in the desired position. The bar is left implanted until the cartilage grows back, typically about 6 months. The bar is then later removed in a simple procedure. The Ravitch technique is no longer widely practiced since it is so invasive. It is often used in older patients when the less invasive Nuss procedure has proven unsuccessful.

Chest Implants

Prosthetic chest implants, or breast implants for woman, are becoming an increasingly desirable surgical solution to remove the cosmetic effects of Pectus Excavatum. In instances of the condition where it is purely cosmetic with no physiological symptoms, it is possible to use solid silicon chest or breast implants to disguise the condition and produce a normal flat appearance for the chest. though, more recently, porex implants have been used in place of silicon, to great effect. small incisions are made in the arm pits or nipples so that cosmetic implants can be inserted and positioned to provide a normal appearance to the chest. The cosmetic procedure is becoming increasingly popular for those with the condition, since it delivers much faster effects, it is much less invasive and requires less time for recovery, and it is also a comparatively cheaper cosmetic procedure. It can be used to great effect to mask the condition and produce a more desirable chest shape, though more severe conditions may not be able to produce a perfectly normal appearance to the chest.

Cosmetic Dermal Filler

The cosmetic appearance of Pectus Excavatum can also be treated with a dermal filler called Bio-Alcamid. This treatment, like with chest implants, can be extremely effective at masking the cosmetic/visual appearance of Pectus Excavatum, producing a more normal appearance to the chest. However, like with chest implants, as it does not address the actual condition itself, it cannot aid with any physiological effects caused by the condition. It can, however, greatly improve the negative psychological effects associated with the condition.

Magnetic Mini-Mover Procedure

The magnetic mini-mover procedure is a relatively new technique used to correct Pectus Excavatum by utilizing two magnets in order to realign the sternum with the rest of the ribcage, producing a flatter appearance to the chest. One magnet is inserted 1 cm deep in the patient, under the lower area of the sternum. The other magnet is subsequently placed onto an external brace which is attached to the patients body. These two magnets generate around 0.04 tesla in order to slowly move the sternum outwards over a number of years. The maximum magnetic field that can be applied to the body safely is around 4 telsa, making this technique safe from a magnetic point of view. The main advantage with this technique is that it is more cost-effective than major surgical approaches such as the NUSS procedure and it is considerably less painful post-op. Since the technique is still in a trial period, it is unknown whether long term wearing of the magnet will affect the skin or other vital organs.

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