Purpose: This study investigated women with pectus excavatum deformity and mammary hyperplasia who underwent correction with either an extended sternal implant or with a mammary prosthesis.

Methods: Eleven women presented for correction of pectus excavatum deformities and correction of mammary hyperplasia. One patient had twice failed reconstruction with a narrow implant and sternal osteotomies. None had pulmonary compromise or decreased exercise tolerance. The width of the sternal defect, the angle of the sternal defect and the amount of desired of mammary augmentation were noted. The sternal corrections consisted of a moulage-designed, extended, silicone prosthesis of 12 durometer. The mammary hypoplasia alone was performed with smooth saline implants. All patients were followed for one year and none were lost to follow-up.

Results: All patients were pleased with the results, except for one who noted fullness in the sternum superiorly. Four patients had an extended sternal prosthesis inserted correcting the mammary hypoplasia and the pectus excavatum deformityThese patients noted that the sternal prosthesis not only corrected the sternal defect but rotated the breast laterally and provided for projection. The seven breast prosthesis patients noted that the implants masked the sternal depression and provided for lateral rotation of the breast. They all felt that the pectus excavatum deformity added to the perception of increased cleavage. The breast implant group had a narrower sternums and had an angle of depression less then that of the prosthesis group.

Conclusion: When confronting a decision to correct pectus excavatum and mammary hypoplasia, customizing the implants to be wider then normal will provide for sufficient increased projection and correction of the appearance of the defect. Breast augmentation alone in the smaller deformities will provide for an improved appearance without actually correcting the deformity. Technical changes in the position of the breast implants and in designing the sternal implants are required.