The patient looked at several before and after pictures and was happy with what he saw. The patient decided it would be worth it to fly into San Diego from Georgia. Upon examination it was determined the  patient that  had lower sternum pectus excavatum. (Pectus excavatum is the most common type of congenital chest wall abnormality.) The patient was extremely happy with his consultation and scheduled his surgery with Dr. Pousti.

During the patients visit to Southern California, a special moulage is taken of the depressed area of the patient’s chest.

The manufactures use this moulage to make the patient’s custom silicone implant.

Markings are made prior to surgery and used to explain what the doctor will be doing during the procedure.

The red markings below indicate the highest amount of depression in the patient’s chest wall. The blue markings indicate where Dr. Pousti will be inserting the pectus implant.

Pectus Implant

The patient is 2 days out of surgery and happy with his initial results.

The patient had some concavity of the chest wall as well causing her breasts to not have the “look” she wanted.  This concavity is sometimes referred to as “pectus” excavatum. In pectus excavatum, also known as funnel chest, the sternum (breastbone) is depressed relative to the rest of the chest wall. Breast implants can be used to camouflage mild to moderate pectus excavatum.

The markings on the breasts show the measurements that Dr. Pousti performs prior to surgery.  The “x” mark indicates where the nipple/areola complex will be moved for better placement of the areola on the breasts.  The breast lift will also give the patient the “perkier” look she wanted.

When performing the breast lift, both areola are reduced in size as well.  On the left breast, the excess skin is also removed for improved symmetry.

Different sized silicone gel implants were used in each breast as well as different profiles.  This was done to achieve the best look possible for the patient.  As you can see below, immediately after both breasts were finished, the results are amazing.  The central “blue” area is where the chest was most depressed and with the breast implants, this depression is camouflaged.  It looks like the patient has deep cleavage.  The patient is almost 2 months out of surgery and extremely happy with her results.

The patient explained to Dr. Pousti that she wanted to not only increase her breast size but was unhappy with a ‘dip’ that she had on her chest wall. After being examined by Dr. Pousti it was determined that the best option for the patient was to augment her breast with silicone gel implants to hide the appearance of her pectus excavatum. Breast implants can camouflage pectus excavatum by giving the patient’s breasts the appearance of “deep cleavage”.

Prior to surgery measurements and markings are made. The markings of the patient’s breast procedure are reviewed the morning of surgery to see if any changes need to be made.

Before Breast Augmentation/Correction of Pectus Exacavatum

Before

Before/Immediately After Surgery

To meet this patient’s size goals and achieve symmetry a 752cc silicone gel implant was used in the patient’s left breast and a 700cc silicone implant was used in her right breast.

The patient is extremely happy with the results of her breast augmentation surgery and pectus excavatum correction.

The markings below, made after careful measurements, indicate where the pectoralis implants will be placed. The line in the middle of the chest is for symmetry purposes.

The sterile implants are then taken out and measured to make sure they are the exact fit for the patient.

Once implants are set in place, the patient is placed in a upright position to make sure that his look is concurrent with the size goals the patient desired.

Dr. Pousti then closes the incisions which are located in the axillary area so that they can be easily hidden.

Before                                                 Immediately After

The patient is extremely happy with his results and is pleased with the new appearance of his chest wall.

During her consultation it was explained to the patient that the dip in her chest was a condition commonly referred to as pectus excavatum. Pectus excavatum is when the sternum (breastbone) is depressed relative to the rest of the chest wall. Breast implants are commonly used for pectus excavatum patients to camouflage the indention. By positioning the correct size/shape of breast implants on the chest wall, the pectus excavatum is camouflaged nicely giving the patient’s breasts the appearance of “deep cleavage”.

Markings as well as the procedure are reviewed with the patient in detail prior to surgery.

The purple arrows indicate where the right breast pocket must be moved up in order to achieve symmetry when the breast implants are in.

To give this patient her desired look a 575cc Silicone implant was placed in the right breast and a 300cc silicone implant was placed in the left.

Immediately After Surgery

The patient is very happy with her initial results of surgery.

During the patients consultation a moulage was made so that it could be sent to construct a custom implant for this depressed area.

Measurements were made prior to surgery to show where the deepest parts of chest wall depression were located. Once measurements are taken, markings are made to show where the implant should be positioned.

An incision is made along the chest wall so that the custom implant can be placed under the pectoralis muscle. The location of the incision is always placed in an area that can easily be hidden.

As you can see immediately after surgery the custom implant filled the depression in the chest wall and created symmetry.

Before

Immediately After

]]> http://www.poustiplasticsurgery.com/case-of-the-week/correction-of-chest-wall-deformity/pectus-excavatum-3/feed/ 0 http://www.poustiplasticsurgery.com/case-of-the-week/procedures-for-men/pec-implants/ http://www.poustiplasticsurgery.com/case-of-the-week/procedures-for-men/pec-implants/#comments Fri, 23 Apr 2010 12:36:51 +0000 nancy http://www.poustiplasticsurgery.com/case-of-the-week/?p=3676 This 38-year old patient from San Diego, California was interested in pectoral augmentation surgery. A friend, who is a patient of Dr. Pousti, referred him. This patient came in to meet with Dr. Pousti regarding male chest wall reconstruction surgery. He was interested in pec implants.

He is now 10-months post-op pec implant surgery and pleased with his results.

In order to achieve his desired look, Dr. Pousti used pectoral 4, (aiache) size 2, textured on both sides.

Her friend, who was a previous patient of Dr. Pousti, referred her. During her consultation, the patient and her husband was able to seeing many before and after pictures of patients who has pectus excavatum and how Dr. Pousti had help them with breast augmentation surgery. The patient and her husband was convinced that Dr. Pousti was the best surgeon for her and after a few consultations, she decided to proceed with surgery.

Dr. Pousti demonstrates the severity of the patient’s pectus excavatum, her right breast is more prominent, while underneath the left breast the chest cavity look a bit more concaved.

Dr. Pousti uses different size implants and carefully creating the breast pockets in order to achieve a more symmetric and desirable look.

Saline breast implants were used; because the left breast was more prominent then right breast, 400cc was filled in the left breast and 500cc was filled in the right breast for symmetry. The patient is now 4-weeks post-op surgery and is very happy with her results so far. The patient continues to heal and will settle over time.

After several phone and e-mail consultations, the patient decided to fly into San Diego to meet with Dr. Pousti in person.

During his consultation, the patient brought in pictures of what he would like to achieve and explained in detail that he wanted the appearance of a more developed pectoral muscle, while still looking as natural as possible. Dr. Pousti discussed the surgery in detail with the patient; measurements were taken at the time, then pectoral implants were selected, the patient decided to proceed with surgery.

The pectoral implant placements were marked in detail according to the planned procedure.

Pectoral 4 Aiache, size 3, textured silicone implants were placed submuscularly.

The body typically produces fluid after pec implant surgery; one drain is placed to prevent fluid build-up and typically after 2 weeks the drain is removed.

Immediately after surgery, you can see the “new” projection of the chest.

The patient is now 1-weeks post-op surgery and is now back in Sacramento, he is very happy with the results of his surgery and will be following up via e-mail and phone with Dr. Pousti.

The patient researched for a San Diego Plastic surgeon who is experienced with patients of her case and found Dr. Pousti from multiple referrals.

During her consultation with Dr. Pousti, the patient expressed she wanted to be symmetric as possible with fullness, the patient was also unhappy with the appearance of her nipples after breast feeding and was interested nipple reduction surgery as well.

Before

In the operating room, markings were made and used as a guide to measure the amount of tissure to be reduced.

Completed nipple reduction immediately after surgery.

The patient is now 2-months post op surgery with 425cc in the right breast and 325cc in the left breast, in order to achieve as much symmetry as possible.

With breast augmentation surgery, the pectus excavatum is no longer visible and now appears to be “deep cleavage” . The patient is extremely pleased with the results of her surgery.