A novel method of minimally invasive repair of pectus excavatum (MIRPE) in patients with bilateral breast prostheses: a report of two patients

Abstract

The literature on minimally invasive repair of pectus excavatum in patients with breast prostheses is very scarce, with only one report to date. We present two cases treated in our center in which this technique was performed without prior removal of the breast prostheses. In one of the patients, a sternal zenithal traction system was additionally used to facilitate retrosternal dissection. In this work, we present the technical details of the procedure. One of the patients presented with postoperative Dressler’s syndrome which resolved with conservative measures. We found no correlation between this complication and the presence of breast prostheses. After 4 and 2 years respectively, both patients are asymptomatic, with an adequate correction of the defect, and being followed up. Minimally invasive repair of pectus excavatum technique is safe and feasible in patients with bilateral breast prostheses. The placement of breast prostheses prior to the correction of rib cage deformities leads to an unpredictable aesthetic result in certain aspects, such as the exact positioning of the nipple areola complex. The approach to this pathology by a pediatric surgeon, who considers not only the aesthetic aspect but also the rib cage involvement and the potential presence of additional malformations (for example, a Poland sequence), is, in the authors’ opinion, beneficial to the overall outcome of these patients.