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Pectus excavatum implant surgery: explaining the procedure, results and cost

Pectus excavatum implant surgery: explaining the procedure, results and cost

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If you’re concerned about having pectus excavatum but don’t want to undergo major cardiothoracic surgery then there is a less invasive alternative. Pectus excavatum implant surgery involves inserting a custom-made 3D silicone prosthetic implant into the concave area of a patient’s chest.

Pectus excavatum implant surgery is low-risk and involves considerably less downtime and risk when compared to more invasive surgeries. Although the procedure doesn’t change the actual shape of the sternum or the rib cage, it can greatly enhance the aesthetics of the chest area and give patients a better quality of life.

Pectus excavatum implant surgery results—what can you expect?

Patients usually see the best results after around two to three months, when any swelling or bruising has gone. After about a year the scar (which will be around eight to ten centimetres) will have faded and be very subtle.

As the implant is custom-made for your anatomy, it will fit perfectly, which means it won’t be uncomfortable in any way. The surgeon inserts the implant below the pectoral muscles and tapers the edges so they smooth over the sternum and ribs. This means the implant will be completely undetectable.

The silicone rubber implants won’t fold, ripple or rupture and won’t need replacing, making this procedure planned as a lifelong pectus excavatum correction.

Before

After

How much does pectus excavatum implant surgery cost?

As with all cosmetic procedures, the cost will vary depending on the clinic at which you have the procedure done and the experience of the surgeon. The cost may also alter depending on the severity of your condition.

As a rough guide you can expect to pay around £6,000–£11,000 for the procedure.

This cost may not include the cost of a CT scan, which is a vital part of the procedure. Information obtained from a CT scan will be used to create a 3D model of your chest and an anatomically correct silicone implant. You won’t be able to have the procedure done without having a CT scan.

CT scans cost around £450–£600 so you would need to factor this into the cost of the operation.

As pectus excavatum surgery with implants is less invasive than the Nuss or Ravitch procedure, it’s much more affordable. The Nuss procedure can cost upwards of £32,000 (source).

Is pectus excavatum implant surgery available on the NHS?

The implant procedure is not currently available on the NHS in most areas.

Invasive surgery to correct pectus excavatum is not available on the NHS either, unless the deformity has been shown to cause significant issues with your heart or lungs.

After reviewing the evidence from a number of studies, an NHS report concluded that “The evidence that was found is not sufficient to conclude that the physical psychological, social and behavioural benefits of surgical treatment of pectus deformities are sufficient to justify its use.” (Source)

What happens before pectus excavatum implant surgery?

Most surgeons will advise you to have a thorough examination to check for any heart or lung problems, before you opt for implant surgery. This is very uncommon but in some patients, pectus excavatum can reduce lung capacity and put pressure on the heart, resulting in symptoms such as:

  • tiredness
  • chest pain
  • heart palpitations
  • frequent respiratory infections

Some of the tests you may have to have include:

  • blood tests—to assess your general health
  • chest x-ray—to check the heart and lungs
  • electrocardiogram (ECG)—to test your heart function
  • pulmonary function tests—to check lung capacity
  • exercise stress testing—to check how well your body tolerates physical exercise
  • CT scan—to check the severity of the pectus excavatum

Even if you haven’t experienced any symptoms from having pectus excavatum, it’s still worth talking to your GP if you’re thinking of undergoing implant surgery. Your GP will be able to discuss any symptoms you’re experiencing and refer you for tests if they think it’s appropriate.

If you do decide to have implant surgery, one test that you’ll definitely need is a CT scan. Experts use the images from the CT scan to generate a 3D image of your sternum, rib cage, muscle and tissue. They’ll use this 3D image as a basis to design a silicone implant that fits your chest exactly.

After your CT scan, it will be around eight weeks until your custom-made silicone mould is ready.

What is the pectus excavatum implant made of?

The implants used to correct a pectus excavatum deformity are made of silicone rubber. This means they are hard and solid, unlike breast implants that are made from silicone gel. Silicone rubber won’t rupture or ripple and won’t need replacing.

The silicone implant is firm in the middle and becomes increasingly smooth at its edges, which are tapered to give the most natural fit possible.

What happens during pectus excavatum implant surgery?

On the day of your surgery you’ll be given antibiotics to reduce the risk of the wound becoming infected. You’ll then be put under general anaesthetic so you won’t feel anything during the operation. You’ll also be given local anaesthetic at the site of your surgery to help manage the pain after you wake up.

After making a small incision of around 7cm, your surgeon will place the implant subpectorally, which means it’ll sit below the chest muscle. This will ensure that the edges of the implant aren’t visible and that the implant stays securely in place.

Your surgeon will close the wound using absorbable sutures and you’ll have a dressing over the wound for eight days. You’ll be given a compression garment to wear 24 hours a day for four weeks to help the wound heal properly.

In some cases, the surgeon will leave a suction drain in place to remove fluids that may build up at the surgery site. However, it’s more likely that if you do have a seroma formation (when fluid collects around the wound), your surgeon will drain this, if needed, during the follow-up consultation eight days after surgery.

The procedure takes around one hour and you’ll have to stay in hospital for up to three days.

You will have a scar at the incision site but this will fade over time.

What happens after pectus excavatum implant surgery?

Most patients recover from surgery after about 4–6 weeks and gradually increase their physical activity during this time. For the first few days after surgery you may be sore so it’s a good idea to get someone to help you around the house during this time.

After about a month you’ll be able to stop wearing your compression garment and resume physical activity such as low-impact sports such as cycling or hiking.

Speak to your surgeon before resuming more strenuous activities, particularly those that involve the chest, such as weight training.

What are the potential complications of pectus excavatum implant surgery?

Pectus excavatum implant surgery is a safe procedure with very few risks. However, as with all surgery, there is still some risk of postoperative complications, including the following:

  • Infection—extremely rare as patients are given antibiotics before and after surgery which greatly reduces the risk of infection. (Source)
  • Swelling and bruising—most people will experience this for the first few weeks but swelling in particular can last for months.
  • Haematoma—it’s rare but some patients experience bleeding around the implant and this usually occurs immediately after surgery, although it can happen later. Haematomas are treated by draining the wound or by further surgery.
  • Numbness—experiencing numbness around the wound area is completely normal and in the vast majority of cases this will gradually subside. However, some patients may find that they have a permanent numbness around the scar.
  • Scarring—you will have a scar after the surgery, but in most cases this will become very faint after about a year. Some patients may find that they have complications relating to their scar including it being raised, hypo-pigmented (white), depressed into the skin or keloid (thick and raised).

If you want to find out more about how pectus excavatum surgery is performed and how Stephen McCulley can help you, contact the clinic today on 0115 962 4535 or email enquiries@stephenmcculley.co.uk.

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