Pectus Excavatum

Breast augmentation is a beneficial surgery for many women that want to add curves to the upper body, but for women with pectus excavatum (chest wall concavity), the results can be even more profound. The deformity caused by pectus excavatum can create a significant impact on a woman’s body contour, which can lead to self-consciousness and even embarrassment for some individuals. Breast augmentation using implants can help a woman distract from the concave effect of the chest and create fuller breasts at the same time.

From Dr. Barrett

“Pectus excavatum creates an extremely difficult breast augmentation environment. Whereas the goal for most breast augmentation patients is to improve cleavage, pectus excavatum patients need the opposite! They need relief from the the center cleavage portion and need their breasts to take on a wider position away from the sunken in appearance of the chest wall. While the breast augmentation doesn’t correct the chest wall deformity, it does create a better focus on the chest and allows patients to fit into bras and clothes better.”

Dr. Barrett has considerable experience and expertise in all types of breast enhancement and has worked with many patients with varying degrees of pectus excavatum. His primary focus is to create a natural and beautiful upper body profile, and he will take the time necessary to produce just the right outcome for you. There are special considerations when planning breast augmentation for a patient with pectus excavatum, and you can rest assured Dr. Barrett will take all factors into account as he helps you prepare for your procedure.


Case #26281

Bilateral silicone breast augmentation

Mentor Moderate Profile Plus Smooth Silicone Implants
Left Size: 175cc
High Profile Smooth Silicone Implants
Right Size: 250cc

What is Pectus Excavatum?

Pectus excavatum is a deformity of the rib cage that may be apparent at birth or become noticeable during adolescence. The breastbone is sunken, creating a concave in the center of the chest. The severity of the deformity can vary significantly, from one that is barely noticeable to a concave that severely affects a person’s appearance and possibly even the function of organs like the heart and lungs. Also known as funnel chest, pectus excavatum can create changes to the appearance that create low self-esteem and even lower quality of life.

Is Breast Augmentation an Option for You?

Fortunately, most women who have pectus excavatum are excellent candidates for breast augmentation, as long as they work with a plastic surgeon that has experience with this deformity. Only the most severe cases that affect the heart and lungs may be contraindicated for the surgery since the anesthesia could pose significant risks in these cases. Dr. Barrett will also consider these factors, as he does before performing any operation:

  • Your general health and chronic medical conditions you might have
  • Whether you smoke, as nicotine can pose additional risks during and after surgery
  • Ability to take enough time off to recover after your procedure
  • Realistic expectations about what the operation can do for you

You and Dr. Barrett will discuss all these various concerns at your initial consultation, so he can advise you on whether breast augmentation could be the right choice for you.

Benefits of Breast Implants for Women with Pectus Excavatum

There can be numerous benefits of breast augmentation in women with pectus excavatum:

  • Less noticeable concave in the center of the chest
  • Correction of breast asymmetries that are common with pectus excavatum
  • Fuller, shapelier breasts with more defined cleavage
  • Breasts are brought into proportion with the rest of the body contour
  • Better fit to clothing, increased self-confidence

Choosing Your Plastic Surgeon

Breast augmentation may seem like a standard procedure, but it requires experience, expertise and an artistic eye to create results that are both natural and beautiful. The need for expertise is particularly true for women with pectus excavatum as there are factors to consider in this situation that are not relevant for other breast augmentation patients. It is also essential to find a surgeon that takes sufficient time and provide you with the attention necessary to make you feel comfortable with the process. Dr. Barrett fits the bill in both cases, so you can rest assured your breast augmentation will be safe and successful.

Factors and Options to Consider

When planning for breast augmentation with pectus excavatum, the choices are very similar. However, the deformity should be taken into account throughout the decision-making process to ensure an optimal outcome. Those choices will include:

Saline vs. Silicone

Implants come as silicone shells that are filled with either a sterile saline fluid or silicone gel. Dr. Barrett often prefers a silicone implant for patients with pectus excavatum, since there is usually less natural breast tissue in these women. The silicone implant is less likely to show rippling. A textured silicone implant is also less likely to migrate toward the center of the breast, which is a frequent concern with placing implants in pectus excavatum patients.

Size and Profile

The size of the implant is particularly critical in a woman with funnel chest. If the implants used are too large, they are more likely to move toward the medial axis, creating an unnatural appearance. The right profile (how far the implant projects from the chest wall) will depend on the severity of the pectus excavatum. In some women, a high profile will further accentuate cleavage, while other women may achieve a better shape to the chest overall with a lower profile.

Placement Choices

Breast implants can be placed over the chest (pectoral) muscle and under the breast tissue, known as subglandular placement. The subglandular option is generally a good placement choice for women that have ample natural breast tissue. Since that is not usually the case for women with funnel chest, submuscular placement, which entails placing the implant underneath a portion of the chest muscle, is typically recommended in these cases. Lateral extension of the pocket is also created to keep the breast implants from moving too close together.

Incision Location

Incision location for patients with pectus excavatum is generally between inframammary (within the crease underneath the breast), or periareolar (encircling the areola). Your choice will depend on the type and size of the implant used and whether there will be any nipple adjustment during the surgery. Dr. Barrett will advise you on the placement that will give you an optimal outcome at your initial appointment.

While the decision-making process may seem overwhelming, Dr. Barrett and his team will walk you through it step-by-step, after listening carefully to your concerns and expected outcome. By the time your surgery day arrives, rest assured you should know exactly what will happen during your procedure.

Procedure Overview

You will have a choice of general anesthesia or local anesthesia with IV sedation for your breast surgery. Dr. Barrett will help you select the right approach after considering the complexity of your procedure, the amount of time surgery is expected to take and your comfort level. Your incisions will be placed as discussed during your previous appointments, taking care to minimize visible scarring afterward. Dr. Barrett will create a breast pocket to place the implants, ensuring the placement will produce a natural and aesthetically-pleasing contour. Dr. Barrett usually takes between one and two hours to complete breast augmentation.

After Your Breast Augmentation

While you are likely to be swollen and sore after your procedure, you should feel up to returning to work and other activities within one week. You will have a surgical bra to wear to support the breasts as they heal, and Dr. Barrett will prescribe medication to keep you comfortable during the first few days. While you may experience some residual swelling and numbness after the first week, it should not be significant enough to keep you from most of your routine. After about one month, Dr. Barrett will clear you for rigorous exercise, allowing your breasts ample time to heal before that occurs.

Creating the Curves You Want

For women with pectus excavatum, the results of breast augmentation can indeed be quite dramatic. In addition to enjoying more voluptuous curves, women are usually happy to discover their deformity is much less noticeable after breast surgery. You should feel more comfortable with your body and more self-confident overall.  Everything fits better. The results of your breast augmentation should be very long-lasting, giving you many years to enjoy your new curves.

While breast augmentation for pectus excavatum patients does have a high patient satisfaction rate, it can be stressful planning for the procedure because there are so many decisions to make along the way. This is where Dr. Barrett truly stands out from other surgeons, ensuring you have all the time you need to feel comfortable with your decisions and happy with your results. To schedule your consultation, contact Barrett Plastic Surgery today at 310-598-2648.

The information about pectus excavatum was reviewed by Dr. Daniel Barrett. If you have any questions, please don’t hesitate to contact us using our contact form below.

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