Pectus Excavatum Questions and Answers (FAQs) is an informative space for the patient. Here you will find the most frequently asked questions and answers to easily understand everything about the corrective treatment of Pectus Excavatum with Pectus Up. A section designed to guide you and help you solve your doubts about the SURGICAL TREATMENT OF PECTUS EXCAVATUM.
There is a genetic predisposition to suffer from these anomalies. A familial occurrence of Pectus Excavatum is seen in approximately 35-45% of cases.
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.
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.
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.
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.
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.
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.
Good posture should be maintained.
Abnormal or rigid postures that a priori can avoid pain should not be adopted, since they can be the cause of other later alterations. It is not advisable to be in a decubitus position (lying down) for a long time.
It is advisable to sleep on the back and avoid lying on the side during sleep (at least during the first month, if possible).
Avoid exposure to risky situations, crowded environments and violent physical contact.
Wide movements of the torso should be avoided, as well as abrupt rotations of the torso, lifting weights or carrying backpacks during the first month.
What is the size of the scar remaining after surgical repair of Pectus Excavatum with the Pectus Up?
The usual size of the scar is about 3-4 cm, approximately the size of the implant width.
If the wound undergoes any change, such as suppuration, swelling and/or opening of any area of the wound, the surgeon should be consulted.
The postoperative period is very little painful and is treated with minor analgesics (ibuprofen, paracetamol, mostly).
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 specialist.
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.
Due to the low pain and good recovery, the operated patients could be incorporated to their daily normality (school, work) a week after the intervention, but depending on the activity involved in their profession is adapted in each case.
It is advisable 2-3 weeks to go to school, and also in the case of sedentary jobs. In other more active professions, consult with the surgeon.
Sleep on your back and avoid lying on your side during sleep (at least during the first month, if possible).
The rest period is about one week after surgery. Relative rest is recommended for approximately one month.
This will consist of resuming daily activities, maintaining good posture and avoiding movements that cause pain.
Refrain from sports activities during the three months following the operation, including weight lifting.
The patient will be able to go to class or to his usual work two to three weeks after the operation, as long as it does not involve sports activities, lifting weights or the use of backpacks, and always respecting the surgeon’s recommendations.
When is the Pectus Up implant removed from the thorax in an adult patient? Can the Pectus Up implant remain implanted forever?
In adult patients, the implant can remain permanently in the thorax and can only be removed by the patient’s will, although not before 3-4 years after the operation.
It will always depend on the evolution of each particular patient, and always at the surgeon’s discretion.
In child or adolescent patients, it will depend on the growth phase they are in (age, height, chest width) at the time of the operation and what changes they undergo in the 3-4 years that follow. An important fact is that Pectus Up never hinders the growth of the thorax.
If there are very significant changes in the person, it can be considered to modify the size of the implant for one adapted to the new size of the thorax. It is a very simple operation in which the sternal plate is kept in the thorax and therefore the bony area is not altered.
Once the implant has been removed, the patient can lead a normal social, academic and professional life.
As with other implants or osteosynthesis material made of medical stainless steel:
- The implant or any of its components may loosen or shift.
- Sensitivity reactions to metals or allergic reactions to the implant material may occur.
- The patient may feel abnormal pain or a sensation of discomfort due to the presence of the implant.
- Wound irritation or infection.
Visualization of the edges of the plate is not possible, as the plate is implanted subpectorally. In patients with pectoralis muscle involvement, each individual patient should be assessed at the time of wound closure.
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.
The device can give positive in the metal detector. It is advisable to carry a document from the manufacturer with the surgeon and hospital data indicating the presence of the metal implant in the thorax.
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.
There is no age limit, although the treatment should be performed as soon as possible, to avoid possible complications derived from the disease itself and possible psychological problems. Pectus Up is indicated both in children and adults, and thanks to the ease of the technique, patients have been operated with good results up to 46 years of age, although these cases are exceptional. The surgical indication will always depend on the type and degree of the Pectus Excavatum and the morphology of the patient, and not so much on his age. It is advisable to evaluate the quality of the bone before surgery to detect possible fragility or osteoporosis in older patients.
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.
Both mild and complex cases (asymmetries, sternal rotation) can be corrected with the Pectus Up with a high success rate, although it will always depend on each individual patient. The indication for surgical treatment of Pectus Excavatum, in general, will be conditioned by the physical or psychological criteria that justify the intervention, and the data extracted from a computerized tomography (CT). If the case is very mild, the indication for surgical intervention should be evaluated with your surgeon.
The size will depend on the dimensions of the thorax and the degree of the Pectus Excavatum, always depending on each particular patient.
Since the first case was performed in 2012, more than 200 operations have been performed on patients with Pectus Excavatum of different ages and degrees of complexity by the end of 2022. Among the operated patients, some have wanted to share their experience in testimonial format, which can be found in the Testimonials section of the Patients section of this website.
Interventions have been performed in countries such as Spain, France, Italy, Portugal, Ireland, Greece, Colombia, Mexico and Chile. Also in Kuwait. See Publications section in the News section of this website. More publications are in the process of being written by the specialized centers.
Up to 35 years of age in general and in older patients the flexibility of the thorax should be assessed in each particular case.
The surgeon must assess the most appropriate treatment indication for the patient. Our specialized engineers, through the review of the CT images (or an MRI), make a detailed report for the surgeon so that he can assess whether or not a patient can be indicated for a Pectus Up, or on the contrary should be treated with another technique.
The medical examinations prior to surgery are the same as in any other surgical intervention.
If there is no surgeon who is monitoring the evolution of your Pectus Excavatum, we can guide you, according to your preferences of region or country, on which are the best professionals who can assess your case.
These surgeons have received specialized training in the technique and at all times are updated on all developments. The company offers personalized support to the professional before, during and after surgery, as required.
In addition, the company informs the patient or family of all aspects that may be of interest to them before surgery, even if it is not performed or if another technique is chosen.
Yes, without any problem. The Pectus Up can improve the aesthetic perception of the patient by also improving the sagging of the central area of the breast and its asymmetry.
It is a technique for repairing the sagging of the thorax, not simply aesthetic, which restructures the thoracic wall even after the removal of the implant. It is performed in a single operation, is very painless and involves a very quick recovery.
In certain cases, the use of the vacuum bell could contribute to give more flexibility to the thorax and therefore facilitate the elevation of the sternum during the operation with Pectus Up. This decision is made by the surgeon.
The use of thoracic implants is not recommended for patients with mental disorders who cannot follow the surgeon’s recommendations.
Are there any disorders that can improve with the implantation of a Pectus Up, since it is a reconstructive technique?
With the implantation of a Pectus Up, certain cardiac disorders derived from the sinking of the sternum could improve, especially in those cases in which there is an oppression or displacement of the heart.
With purely aesthetic techniques, and therefore not reconstructive, other disorders cannot be improved.
Yes, there is experience with Pectus Up implantation in these cases.
It is a very simple operation that is performed without risk and lasts about 45 minutes.
Yes, the patient will be given general anesthesia in a conventional operating room.
How long are patients who have undergone Pectus Excavatum surgery with the Pectus Up usually hospitalized?
Patients usually stay in the hospital an average of 2 days after the surgical repair, depending on the age and the degree of the Pectus Excavatum.
It is not ruled out that in the medium term the intervention can be carried out through a process of Major Ambulatory Surgery.
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.
There are no serious risks and other minor risks are the same as with any medical steel implant, or osteosynthesis material used in fractures.
Relative rest, trying to avoid movements that cause pain, and gradually resume daily activities.
Perform gentle breathing exercises on a daily basis, for example, breathe in gently until the chest is completely full, then breathe out slowly until the lung is empty.
Until the first month, you can move your trunk and raise your arms gently and gradually, acclimatizing to the new situation successively and continuously, without causing pain.
Always depending on the evolution of each patient, taking into account that recovery is faster the younger the person is, you can go to school, college or to the usual work from the first review with the surgeon, if the surgeon considers it and the patient feels well.
Beginning of sporting activity between three and six months after surgery, depending on the type of activity, but avoiding high-risk sports or those involving movement of the torso such as golf, tennis, bench exercises, etc., for a period of six months.
Metal fixation devices or thoracic implants are generally not capable of withstanding the levels of activity and loads that a normal, healthy chest wall can tolerate.
If the instructions recommended by the surgeon are not followed, the Pectus Up may become loose or dislodged if it is subjected to weight or load bearing or very intense activities, or if the patient suffers any trauma to the thorax.
Failure to follow postoperative instructions may result in complications. See the section on complications.
In any implant (for reconstruction or esthetic) it must be taken into account that the wide movements of the thorax after surgery can compromise a good fixation of the implant.
Do not perform any type of physical activity that implies torsion of the torso or lifting weights during the first 3 months.
You will be able to practice sports activities after three months, depending on the sport practiced. Sports such as golf, tennis or bench exercises will require a little more time, around 6 months, since they involve a wide movement of the torso. It will always depend on the surgeon’s consent.
After surgery, activities of daily living should be resumed progressively, avoiding movements that cause pain.
Resume sports activities at school after 3 months, depending on the type of activity. It is advisable to consult the surgeon in case he/she considers it convenient.
Reinforce the fact that children and adolescents, with the help of their relatives, should not do any type of physical activity during the first 3 months, since they may not be aware of the relevance of following the instructions, as they are not in pain and their recovery is very fast. Extreme caution should be exercised in their school and extracurricular activities.
Avoid violent physical contact. Rotations of the torso and lifting weights should be avoided during the first month.
Intense sports activities should not be started before six months after surgery and sports involving torso movement such as golf, swimming, tennis, weight lifting, bench presses, etc. should be avoided, depending on the condition of the thorax and the surgeon’s approval.
Any contact sport should be avoided during the first six months, at least, because severe trauma to the anterior thorax can lead to severe intrathoracic injuries. In case of doubt, always consult the surgeon.
Pectus Excavatum Questions and Answers (FAQs): Did you know that Pectus Up is a corrective solution aimed at prioritizing patient health and safety? Therefore, in this section, the information provided is not intended to replace in any way the advice that a doctor or other specialist health professional can provide.
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