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Plastic Surgery/pectus excavatum

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Question
"Dear sir,

I'm Niranjan (age 29)from colombo, Sri Lanka. I've a problem in my chest. Middle area of my chest went inside (pectus excavatum)and it's looks bad. I remember that, this is from in my age of 14. At that time I thought this is because of i'm too slim. Until now I thought that this is only for me in the world.
Today I came to know this is a common to all.

1)I've wesing problem ( Difficult to breath) when cold climate & due dust. I've doubt this is due to my chest deformity.
2) I want to know , are there any affects (heart problem/chest problem) due to this deformity.
3) Is it compulsory to do surgery or i can live with this through out my life.
4) Are there any side effect due to the treatment e.g-Nuss procedure or vacuum.

Kindly clear my doubt sir, i was mentally upset due to this chest appearance for a  long time.

Thank you.
G.Niranjan"

Answer
Dear Niranjan

Sorry for the delay, but this is the first I received your question.

Most of the time, pectus excavatum is only a cosmetic problem, but in very severe cases it can lead to heart or lung problems.  If it were severe enough to cause these problems, they generally would occur all the time.  Your symptoms seem seasonal, and so, they are not very likely the result of the pectus excavatum.  Surgery is only required if there are functional problems.  If so, this is a fairly major procedure there most commonly involves removal and reversal of the depressed sternum and ribs.  This procedure is generally done by a thoracic surgeon rather than a plastic surgeon.

Without functional reasons for surgery, there is no need to consider correction unless you desire to do it for cosmetic reasons, in which case the most common correction would consist of insertion of a silicone implant above the depressed area.  We do this endoscopically (using telescopes) though a small incision.  The operation is quite safe, but as with any surgery, there exist the possibility of complications.  The most common is the build up of fluid around the graft, which could require drainage for a period of time.

In summary, severe pectus excavatum can cause significant pulmonary or cardiac problems, but in most cases is only a cosmetic deformity.  Your personal physician should be able to advise you if your difficulty breathing is related to obstruction from the deformity or is related to allergies or other problems.

Sincerely
Howard Tobin, MD FACS

Plastic Surgery

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Howard Tobin MD FACS

Expertise

I can answer questions related to Cosmetic Surgery. I cannot answer questions related to reconstruction, burn treatment, cleft palate surgery or traumatic surgery. My practice is, and has been for 36 years, limited to Cosmetic Surgery. For further information, go to www.newlook.org

Experience

As mentioned above, I have exclusively practiced cosmetic surgery for over 36 years. My practice encompases all aspects of cosmetic surgery

Organizations
American Academy of Cosmetic Surgery (past president) American Society of Liposuction Surgery (past president) Cosmetic Surgical Society of Texas (past president) Fellow American College of Surgeons Texas Medical Association see cv on website www.newlook.org for further details

Publications
Seventy three published articles. see cv on website www.newlook.org for further details

Education/Credentials
Graduate of Princeton University and Baylor College of Medicine Internship - University of Virginia Residency - Baylor Medical College Affiliated Residencies Fellowship - University of Cincinnati see cv on website www.newlook.org for further details

Awards and Honors
American Medical Association - Physician's Recognition Award; 1969- present American Academy of Otolaryngology - Head and Neck Surgery Honor Award, October, 1983 American Board of Cosmetic Surgery - Certificate of Appreciation - 1987 American Academy of Cosmetic Surgery - Best presentation at 1987 annual meeting: "Revision Mammaplasty with Replicon Prosthesis" Accreditation Association for Ambulatory Healthcare Certificate of Appreciation 1989-90 American Academy of Facial Plastic & Reconstructive Surgery Honor Award for distinguished service, 1989 American Academy of Facial Plastic & Reconstructive Surgery Appreciation Award for authorship of monograph on outpatient surgery , 1993 Certificate of Excellence in Continuing Medical Education in Cosmetic Surgery, 1993 - American Academy of Cosmetic Surgery. International Academy of Aesthetic Surgery & Aesthetic Medicine - Honor Award, 1994 American Academy of Cosmetic Surgery - Recognition plaque following term of Presidency - 1995 Accreditation Association for Ambulatory Healthcare Special Citation of Appreciation for Service; November 1996 International Academy of Aesthetic Surgery & Aesthetic Medicine - Appointed honorary North American President, 1995 1997 American Academy of Cosmetic Surgery: Award for excellence in cosmetic surgery; Jan 2003 Cosmetic Surgical Society of Texas Appreciation Award for Leadership; 2004 Honorary Member Mexican Academy of Cosmetic Surgery 2007

Past/Present Clients
A past sponsor of the Miss Texas USA pageant, he has also served as a judge for this and other pageants. His patients include many pageant contestants and winners up to the Miss Universe title

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