FAQS

how you can solve your doubts about the SURGICAL TREATMENT OF PECTUS EXCAVATUM

Frequent questions

It is not intended that the information we offer you in this section replaces in any way the advice that a doctor or other specialized health professional can provide. For all these reasons, it is advisable to follow the instructions of the surgeon at the time of discharge and during medical visits and to consult an expert professional to obtain the information that you need or that is most convenient for you. For more details go to LEGAL NOTICE AND PRIVACY POLICY.

PRE-INTERVENTION

What is the best age for surgical treatment of Pectus Excavatum?

The ideal age to intervene in a patient with symptomatic Pectus Excavatum is prepubertal age (12-14 years) to avoid possible complications derived from the disease itself and the psychological problems that may appear. That said, thanks to the ease of the Pectus Up technique, adult patients can also benefit from surgical treatment with this new technique.

What age is recommended for pediatric patients?

For pediatric patients, surgical repair of Pectus Excavatum was previously recommended in symptomatic cases as soon as possible. However, it has recently been shown that the results are not as positive in very young children and, for this reason, it is currently recommended to delay the age of surgery, establishing the optimal age from 8 years.

Is there an age limit for Pectus Excavatum surgery to be performed with the Pectus Up method?

There is no age limit, although the treatment should be carried out as soon as possible, to avoid possible complications derived from the disease itself and possible psychological problems.
Thanks to the ease of the technique, adult patients can also benefit from surgical treatment. Patients up to 46 years of age have been operated on with good results, although these cases are exceptional.
The surgical indication will always depend on the type and degree of Pectus Excavatum and the morphology of the patient, and not so much on her age.

Is Pectus Excavatum hereditary?

There is a genetic predisposition to suffer from these anomalies. A familial occurrence of Pectus Excavatum is seen in approximately 35-45% of cases.

Is physical exercise recommended for an adult affected by Pectus Excavatum?

It is always advisable to practice exercise so that the patient adopts a correct posture and improves her physical condition. In people affected by Pectus Excavatum it is advisable to perform stretching and breathing exercises to increase lung capacity. It is advisable to practice swimming as it facilitates this aspect and also strengthens the muscles.

Can gymnastic exercises correct or improve Pectus Excavatum?

The performance of gymnastic exercises will serve as a complement to provide improvements in terms of breathing, strength and resistance, without correcting the malformation, although it does improve the muscular and physical part in general. Exercises to muscle the upper trunk area can be performed and can improve the aesthetic appearance, although care must be taken since, on occasions, the result may be the opposite, that the sinking is still perceived plus. We recommend seeking advice from specialists in this matter.

What kind of activities are the most advisable?

The best option for improvement is, without a doubt, stretching. The practice of stretching allows the chest to be stretched so that the cartilage attached to the sternum and the adjacent ribs adapt to condition an upright posture.
Therefore, stretching will be key when it comes to correcting, in a certain way, the appearance of the Pectus Excavatum. It should not be forgotten that warm-up exercises will be essential for good adaptation and to avoid abnormally overstretching different parts of the body.

When should a patient receive surgical treatment for their Pectus Excavatum?

The indication to undergo surgical treatment with Pectus Up will be based on the clinical diagnosis of Pectus Excavatum, provided that it meets the requirements described in the treatment chapter of Pectus Excavatum of this web page. However, the decision will always depend on the surgeon’s criteria and the patient’s own acceptance.

What type of deformity, mild or severe, is ideal to be treated with the new Pectus Up implant?

The indication of surgical treatment of Pectus Excavatum, in general, will be conditioned by the physical or psychological criteria that justify the intervention. In the case of treatment with the new Pectus Up implant, both mild and severe cases can be corrected with a high success rate, although it will always depend on each particular patient. In very specific and complex cases, the Pectus Up technique can be complemented with other surgical procedures.

Does the Pectus Up have a standard size or is it adapted to each patient?

The size will depend on the dimensions of the thorax and the degree of the Pectus Excavatum, always depending on each particular patient.

What are the results of patients operated on with Pectus Up?

Up to the end of October 2021, more than 170 interventions have been performed on patients with Pectus Excavatum of different ages and degrees of severity. Among the operated patients, some have wanted to share their experience in testimonial format, which can be found in the section Testimonials from the Patients section of this website.
Interventions have been carried out in countries such as Spain, France, Portugal, Ireland, Greece, Colombia, Mexico and Chile. The first case was performed in 2012, and 15 implants have already been removed with good results. Its publication is in the process of being written by the specialized centers.

Is it a high-risk surgery among surgical treatments for Pectus Excavatum?

No, the Pectus Up technique is minimally invasive and involves surgical repair of Pectus Excavatum, extrathoracic and without high risk. When using general anesthesia, we cannot rule out that the patient may suffer some complication as in any other surgical procedure under the same conditions.

Is the patient under anesthesia during the Pectus Excavatum procedure?

Yes, the patient will be given general anesthesia in a conventional operating room. It is not ruled out that in the medium term the intervention can be carried out through a process of Major Ambulatory Surgery.

POST INTERVENTION

How long are patients who have undergone Pectus Excavatum surgery with the Pectus Up usually hospitalized?

Patients typically stay in the hospital 1-3 days after surgical repair, depending on age and the degree of Pectus Excavatum.

What is the size of the scar that remains after a Pectus Excavatum surgical repair with the Pectus Up?

The usual size of the scar is about 3-4 cm wide.

What are the common cares that will have to be carried out right after a Pectus Excavatum surgery with the Pectus Up?

You must be careful with personal hygiene to avoid possible infections. The wound cannot be touched or wet. In addition, the dressing will not be able to be lifted until the first check-up with the surgeon. It is recommended to practice deep breathing exercises several times a day.

What to do if alterations appear in the wound?

If the wound undergoes any changes, such as suppuration, swelling and/or opening of any part of the wound, the surgeon or hospital should be consulted.

What to do in case of pain?

It is necessary to follow the instructions of the analgesic therapy prescribed after medical discharge. In case of experiencing pain, you can take the analgesics recommended by the surgeon, and if the pain persists, the patient should contact him.

What type of analgesia is required after Pectus Excavatum surgery?

Analgesia prescribed by ibuprofen or paracetamol, mostly.

What precautions should I take after Pectus Excavatum surgery with Pectus Up?

Good posture should be maintained.
Anomalous or rigid postures that a priori can avoid pain should not be adopted, since they can be the cause of other subsequent alterations. It is not advisable to spend a long time in a decubitus position (lying down).
It is convenient to sleep on your back and avoid being on your side during sleep (at least during the first 3 months).
Avoid exposure to risky situations, environments with crowds of people and violent physical contact.
You shouldn’t do sudden torso rotations, lift weights or carry backpacks during the first month.

When will I be able to lead a normal life once the Pectus Up procedure has been carried out?

The expression “normal or daily life” is relative. The reference would be a person who performs social, family, work or academic activities with a medium-low level of physical activity (without activities that carry a high risk).
After surgical repair of Pectus Excavatum with the Pectus Up method, the patient should rest for about a week after surgery, and relative rest for about a month is recommended.

Should you sleep in a specific position after Pectus Excavatum surgery with the Pectus Up?

Sleep on your back and avoid being on your side during sleep (at least for the first 3 months).

How long is the rest period and what does it consist of?

The rest period is about a week after the intervention. A relative rest of a duration of approximately one month is recommended.
This will consist of resuming activities of daily living, maintaining good posture and avoiding movements that cause pain.
Refrain from sports activities for three months after the operation, including weight lifting.
The patient will be able to go to class or to his usual job two weeks after the intervention, always respecting the surgeon’s recommendations.

What activities or exercises can be done during the first month?

Relative rest, trying to avoid movements that cause pain, and gradually resume activities of daily living.
Perform gentle breathing exercises on a daily basis, such as gently inhaling until the chest is completely filled; then exhale slowly until the lung is devoid of air.
You can gradually move your trunk and raise your arms, acclimatizing to the new situation successively and continuously, without causing pain.

What activities can be performed after Pectus Excavatum surgery with the Pectus Up?

Always depending on the evolution of each patient, bearing in mind that the younger the person is, the faster the recovery is, se can go to school, university or to regular work at from the first review with the surgeon, if he considers it and the patient feels well.
Start of sports activity between three and six months after the intervention, depending on the type of activity, but avoiding high-risk sports or those that involve movement of the torso such as golf, tennis, etc., for a period of six months.

What should be taken into account when starting activities after surgery with Pectus Up?

Metal fixation devices or thoracic implants are generally not capable of withstanding activity levels and loads tolerated by a normal, healthy chest wall.
In the case of not following the instructions recommended by the surgeon, the Pectus Up can loosen or move if it is subjected to weight bearing or loads or very intense activities, or if the patient suffers any trauma to the chest.
Failure to follow postoperative instructions could lead to complications. See the complications section.

When can I start sports activity after a surgical treatment of Pectus Excavatum with the Pectus Up?

You will be able to carry out sports activities from the age of three months, depending on the sport practiced. Sports like golf or tennis will require a little more time, as they involve extensive movement of the torso. It will always depend on the consent of the surgeon.

Will it be possible to carry out sports activities at the school?

After the intervention, activities of daily living should be resumed progressively, avoiding movements that cause pain.
Sports activity can be resumed at school one month after the intervention, although it will depend on the type of activity. It is advisable to consult the surgeon if he considers it appropriate.

What activities should be avoided?

Avoid violent physical contact. Rotations of the torso and lifting weights should be avoided during the first month.

What sports should be avoided?

It is not necessary to start intense sports activities before six months after the intervention, as well as avoiding sports that involve movement of the torso, such as golf, swimming, tennis, weights, etc., depending on the state of the chest and approval of the surgeon.
Any contact sports should be avoided for at least the first six months, because severe trauma to the anterior chest can cause severe intrathoracic injury. In case of doubt, always consult the surgeon.

How long after the operation will it be possible to travel on vacation?

You can travel for vacations, as long as you maintain a good trunk position and avoid exposing yourself to risky situations.
Do not lift or hold suitcases, or lift weights, for at least one month.
Avoid crowded environments.

What precautions should be taken when traveling by plane?

The device may test positive in the metal detector. It is advisable to carry a document from your surgeon indicating the presence of the metal implant in the chest.

When is the Pectus Up implant removed from the chest? Can the Pectus Up stay implanted forever?

Initially it remains implanted between three and four years, but in some cases it may be longer and even permanently. It will always depend on the age and especially on the evolution of each specific patient, and always at the discretion of the surgeon.

Is it difficult to remove the Pectus Up implant?

No. Plaque removal is a brief surgical intervention that is usually performed without hospital admission for adolescent and adult patients. Once the implant has been removed, the patient can lead a normal social, academic and professional life.

What are the possible side effects after the intervention?

  • The implant or any of its components may become loose, displace, or break.
  • Metal sensitivity or allergic reactions to the implant material may occur.
  • The patient may experience abnormal pain or discomfort due to the presence of the implant.
  • Wound irritation or infection.
  • Incomplete or inadequate correction of the deformity, or its recurrence, before or after implant removal.
  • The implant may need to be removed if the patient experiences any of the effects described above.

Can a computed tomography (CT) be performed after undergoing Pectus Excavatum surgery with the Pectus Up technique?

A CT can be performed although the image of the chest may be somewhat distorted (artifacts). MAGNETIC RESONANCE CANNOT BE PERFORMED.

Will the edges of a plaque be apparent on the surface of the skin?

In very, very thin patients, plaque may sometimes be noticeable under the skin in the central area. If the surgeon contemplates this possibility, a small modification in the technique can be made at the final moment of the intervention. In the rest, visualization is not possible since it is implanted subpectorally.

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