title: [Management of breast asymmetry associated with primary funnel chest].
abstract: OBJECTIVE
  The funnel chest or pectus excavatum (PE) is the most common congenital deformity. In women, it can be associated in some cases with breast asymmetry. It is the main cause of consultation in these patients. We report our management of this malformation by thoracic silicone prothesis modeled by computer-aided design.
  
  
  METHODS
  Two correction procedures are proposed: One-stage procedure including thoracic silicone prothesis or breast implants only, or two-stage procedure by the combination of the two techniques in two steps.
  
  
  RESULTS
  Between 1998 and 2011, 31 patients had a PE, within 26 patients were treated for breast asymmetry associated with a PE. The average age was 23.1 years (15-39). The median follow-up was 65 months (24-86). Type I Chin was found in five cases (19%), type II in two cases (7.7%) and type III Chin was found in 19 cases (73%). Of these 26 patients, in both cases a breast augmentation with asymmetric volumes of implants (7.7%) has adequately corrected the problem. Thoracic endoprothesis was performed in 24 patients to treat the initial breast asymmetry. Twenty-one patients (87.5%) were satisfied with the final symmetry and have not required a breast augmentation. Three patients (12.5%) underwent a second surgical procedure to correct the initial breast asymmetry.
  
  
  CONCLUSIONS
  Breasts asymmetries associated with PE can be adequately corrected using an isolated thoracic endoprothesis. Whether it remains a lack of results, perform an unilaterally or bilaterally breast augmentation in a second time is always possible.
authors.affiliation: Service de chirurgie plastique et reconstructrice, CHU de Toulouse-Rangueil, avenue du Professeur-Jean-Poulhès, 31059 Toulouse, France. choquoc69@gmail.com
authors.forename: C
authors.initials: C
authors.lastname: Ho Quoc
authors.forename: B
authors.initials: B
authors.lastname: Chaput
authors.forename: I
authors.initials: I
authors.lastname: Garrido
authors.forename: A
authors.initials: A
authors.lastname: André
authors.forename: J-L
authors.initials: JL
authors.lastname: Grolleau
authors.forename: J-P
authors.initials: JP
authors.lastname: Chavoin
mesh_terms: D000293:Adolescent; D000328:Adult; D001940:Breast / Q000002:abnormalities*; D018427:Breast Implants; D017076:Computer-Aided Design; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D012086:Reoperation; D012826:Silicone Elastomers; D013249:Sternum / Q000002:abnormalities* / Q000601:surgery*; D035441:Thoracic Wall / Q000002:abnormalities* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D012826:Silicone Elastomers