Treatment of funnel-shaped thoraxes with custom-made silicone prosthesis
The strong points
- a revolutionary surgery that allows you to obtain a customized correction of your deformity
- reliable treatment of pectus excavatum in women is finally possible
- a surgery with little pain and a 5 cm scar under the breast
Principles of funnel chest treatment
The funnel-shaped thorax or pectus excavatum is the most frequent anterior thoracic malformation. It leads to deformities responsible for an important aesthetic discomfort and very little functional discomfort except in very advanced cases. Its surgical treatment allows an important gain in quality of life.
Funnel chest is defined by a concavity of the central thoracic region (sternum) associated with an excess of curvature of the costal cartilages. It affects 1% of the population, mostly men, and appears during growth. There are 3 types of funnel chest according to Chin's classification:
Type 1 : the malformation is symmetrical and concerns only the sternum
Type 2: the deformity is symmetrical and extends to the pectoral regions
Type 3 : the malformation is asymmetrical and extends to the pectoral regions
There are 2 types of funnel chest surgery
- Sternochondroplasty: is performed by thoracic surgeons and consists of modifying the structure of the costal cartilages and the sternum by means of sections stabilized by titanium plates. It is a heavy and painful procedure. It is reserved for patients suffering from significant functional impairment (discomfort) of breathing. A minimally invasive technique called Nüss consists in introducing a convex titanium rod into the thorax in order to project the sternum. It is interesting in types 1 and 2 during the growth period between 13 and 18 years of age.
- The fitting of a custom-made silicone prosthesis: this is the procedure that we perform. It is intended for patients suffering from a purely aesthetic discomfort which corresponds to the majority of cases. This aesthetic surgery of the torso consists in introducing under the skin or under the pectoral muscles a solid silicone prosthesis (no possibility of rupture of the implant).
The correction of pectus excavatum by silicone prosthesis has recently been revolutionized by the application of computer-assisted design techniques. Previously, the implant was made from a plaster mold made by applying alginate (a borrowed paste used by dentists) to the patient's thorax by a specialized technician. This method of cosmetic surgery of the torso had its limits, particularly in women (the volume of the breast prevents the taking of a reliable print), and in Chin type 3.
From now on, we only use methods based on the creation of 3D models from a volumetric scanner reconstruction of the patient.
This method allows a millimeter adaptation of the implant to fill the area.
The implant is then manufactured by the SEBBIN laboratories in solid silicone elastomer. It does not present any risk of rupture and its lifespan is estimated at more than 25 years.
It is placed under endoscopic control (using a camera), most often under the skin, especially in women, and sometimes under the pectoral muscles in very thin men.
An initial consultation with your plastic surgeon is necessary to explain the risks and benefits of such an operation.
A thoracic scan will be prescribed and you will be given a quote from the Sebbin laboratories.
A specific compression garment will also be prescribed.
This scan must be analyzed by your surgeon and will be sent to the Sebbin laboratories for planning and production of the implant. This stage lasts on average 1 month.
Finally, a pre-anesthetic consultation must be performed at least 48 hours before the operation.
Questions / Answers
What are the possible complications?
A small risk of a hematoma (blood clot in the operating room) is possible in the 48 hours following the operation. In this case, it is necessary to return to the operating room.
As with any implant, a post-operative infection is rare but possible (less than 1% of cases). In this case, the implant must be removed and an antibiotic treatment must be given.
The most frequent complication is the occurrence of a lymphatic effusion which occurs in more than 20% of cases. If it is large, it may require a puncture.
The edges of the implant may be visible especially in very thin patients. A correction by injection of purified fat can be considered in a second time.
What are the steps to take before considering cosmetic surgery for a funnel chest with a custom-made silicone prosthesis?
An initial consultation with your surgeon is necessary to explain the risks and benefits of funnel chest surgery.
A thoracic scan will be requested and an estimate will be established by the Sebbin laboratories after a medical prescription.
A deposit of approximately 700 € will be requested before starting the manufacturing of the implant.
This scan will then be analyzed by your surgeon and will be sent to Sebbin Laboratories for planning and production of the implant. This stage lasts on average 2 months.
Finally, a consultation with your anesthesiologist will take place in the month preceding the operation.
Is the procedure covered by health insurance?
Yes, the surgical act of placing a custom silicone implant is covered by health insurance as well as hospitalization.
However, the implant itself is not covered and its cost varies between 1200 € for an implant made after casting to 2300 € for an implant designed by computer from a scanner.
A deposit check payable to the SEBBIN laboratory will be requested before the implant is manufactured.
Finally, the surgeon's fees (2500 €) may be reimbursed by your health insurance.
How much does funnel chest surgery with a custom silicone prosthesis cost?
In case of coverage by the health insurance, our surgical fees amount to 2500 € possibly covered by your mutual insurance company.
The implant is not covered by health insurance or by your health insurance company. Its cost varies between 1200 and 2300 euros depending on the design method chosen (casting or CAD).
To learn more about the treatment of Pectus Excavatum on the Anatomik Modeling website, click here.
Have a question? Please contact us!
Docteur Yaël Berdah et Docteur Marc-David Benjoar
Chirurgiens esthétiques à Paris France