The most popular questions and answers on the treatment of Pectus Excavatum and Poland Syndrome with a custom 3D implant.

How does the surgery take place? How long is the hospital stay?

The surgery takes place under general anaesthetic and lasts less than an hour. Hospitalisation lasts 3 days.

Are there risks associated with the surgery? Are there risks of rejection of the implant?

The risks of haematoma are rare (3 out of 400 recorded cases) and there is no risk of immune rejection insofar as the implant is a foreign body made up of silica molecules, unknown to the organism that cannot produce antibodies.

Are postoperative follow‑ups painful?

Postoperative follow‑ups are little painfull, treatment with simple analgesics

What monitoring/supervision must be done after the surgery?

The postoperative oedema produces a serous effusion (seroma) that must be punctured 8 days after surgery, which is painless. The puncture may be repeated as appropriate.

When can you resume playing sports? What types of sports?

The complete and solid healing of the suture of the two pectoralis major muscles between them takes a year. The practice of sport is forbidden for 3 months and must be resumed in a progressive and non-violent way for one year. Sports involving sudden movements of the pectoral muscles, are not recommended for one year (push-ups, core-strengthening exercises, climbing, tennis, golf, contact sports, etc.).

As sutured together, the forced contraction of the two pectoral muscles could lead to a transverse movement visible under the skin. There is no functional discomfort or secondary atrophy, but patients practicing bodybuilding should be warned.

Do you stop working? For how long?

It is advised that you do not work for 15 days for people with sedentary jobs and 30 days for those with physically demanding jobs.

How long does the implant last?

The implant is in place for life: it is unalterable, indestructible, unbreakable, and cannot undergo retractable hull, unlike breast implants filled with silicone gel.

What is the implant made of?

It is an elastomer made from medical grade silicone, supplied by NuSil, the world leader in medical silicone. Its consistency is that of a more or less flexible gum depending on the thickness and the indication. The implant is not made from silicone gel like breast implants As such, the implant is inalterable, unbreakable and indestructible.

What steps should I undertake to have surgery? What preliminary screenings?

You should first consult an advisory or referring surgeon. Then have a 3D scanning done of your thorax and digital photos of front and ¾ left and right taken.

Where can I go to have surgery? How to choose a surgeon?

We refer you to doctors who can do the surgery (see the map of referral centres). These surgeons are recognised in their profession and have received specific training to be able to insert our custom‑made implants. The list of referral centres increases monthly.

At what age can you have the surgery?

You can have the surgery from 15 years old, after puberty. And until you are about 60.

Can you combine the insertion of these custom‑made implants with breast implants?

Yes but in two surgeries, spaced at least 6 months apart, starting always with the thoracic implant. If breast asymmetry is due to Pectus Excavatum, the mere presence of the thoracic implant can sometimes correct the asymmetry and increase the size of the breasts.

Regarding the Pectus Excavatum, what is the advantage compared with the Nuss or Ravitch techniques?

This technique requires only one surgery, without orthopaedic change to the chest cavity, and therefore much less invasive, painful and disabling. This technique does not present any risk of recurrence or poor performance.

Regarding the Pectus Excavatum, can the suction bell (Vacuum Bell) avoid such a surgery?

It is supposed to do so, but to date this has not been demonstrated by sufficient scientific work (evidence‑based medicine). Moreover it is a cumbersome constraint for a child.

Regarding the Pectus Excavatum, is this technique recommended in case of functional disorders like breathing difficulties?

No, this technique does not claim to correct functional, cardiac or respiratory disorders which may be caused in very rare cases by a Pectus Excavatum. A lung specialist should be consulted who may refer the patient to a thoracic surgeon. It is the thoracic surgeon who will be able to determine the most appropriate technique, between a Nuss or Ravich reconstructive surgery or a custom‑made implant.

Can you get a custom-made implant if you already performed a Nuss or Ravitch surgery ?

Patients who had to remove a Nuss or Ravitch bar or either are not satisfied with the morphological results of those techniques can get a 3D custom-made implant. This filling technique presents minimal risks and fits perfectly to asymetric Pectus, hard to treat with traditional orthopedic surgeries.

At what age can you get the custom-made implant technique?

Pectus can be operated from 14/15 years old, after puberty as the thoracic deformity is no longer evolving. Concerning Poland, it is safer to wait until the body is fully developped, especially for girls, so it would be 18 years old. You can be operated until 60/65 years old if you are in good physical health.