title: Pectus excavatum in adult women: repair and the impact of prior or concurrent breast augmentation.
abstract: BACKGROUND
  Women present with pectus excavatum five times less frequently than men. Adult women may have additional, associated cosmetic factors, including hypoplastic or asymmetric breasts, or prior augmentation. The authors evaluated the impact of prior or concurrent cosmetic breast surgery in an adult female cohort undergoing repair of pectus excavatum deformity.
  
  
  METHODS
  A retrospective review was performed of women (≥18 years old) who underwent pectus excavatum repair at a single institution from January of 2010 to September of 2013.
  
  
  RESULTS
  Pectus excavatum repair was performed on 47 women with a median age of 35 years (range, 18 to 63 years). Mean pectus severity index was 6.2 (range, 3.1 to 16). All patients had physiologic symptoms as the primary purpose for seeking repair. Twenty patients (43 percent) presented with existing implants or the desire for implants at the time of repair. Fifteen patients (32 percent) had a history of implant placement including prior breast augmentation (n = 14) and/or pectus implant (n = 4). Concurrent augmentation (n = 5), breast implant exchange (n = 8), and/or removal of chest wall implants (n = 4) was performed during repair. Morbidity included one implant-related hematoma. Complications and hospital stay were not significantly different for patients undergoing primary repair alone versus those with prior or concurrent augmentation.
  
  
  CONCLUSIONS
  Breast cosmesis was a concern in nearly half of adult women presenting for pectus excavatum repair. The authors' experience suggests neither prior nor concurrent breast augmentation increases the risk of complications in repair. The authors recommend that cosmetic breast surgery be performed concurrently with pectus excavatum repair.
  
  
  METHODS
  Therapeutic, III.
authors: Phoenix, Ariz. From the Department of General Surgery and the Divisions of Plastic and Reconstructive Surgery and Cardiothoracic Surgery, Mayo Clinic Arizona; the Division of Pediatric Surgery, Phoenix Children's Hospital; and the University of Arizona College of Medicine-Phoenix.
authors: Irene T
authors: IT
authors: Ma
authors: Alanna M
authors: AM
authors: Rebecca
authors: David M
authors: DM
authors: Notrica
authors: Lisa E
authors: LE
authors: McMahon
authors: Dawn E
authors: DE
authors: Jaroszewski
mesh_terms: D000293:Adolescent; D000328:Adult; D019928:Breast Implantation / Q000706:statistics & numerical data; D018427:Breast Implants / Q000706:statistics & numerical data*; D002637:Chest Pain / Q000209:etiology; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology; D004954:Esthetics; D017079:Exercise Tolerance; D005260:Female; D005660:Funnel Chest / Q000150:complications / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016462:Mammaplasty / Q000706:statistics & numerical data; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000523:psychology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000209:etiology; D055815:Young Adult
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