An Open, Prospective Study to Evaluate the Effectiveness and Safety of Hyaluronic Acid for Pectus Excavatum Treatment

Can a Breast Augmentation Procedure Improve the Appearance of Pectus Excavatum Deformity in Female Patients? A Prospective Study

Background

This study evaluates a specific breast augmentation (BA) technique in patients with pectus excavatum(PE) and its results in improving this deformity, augmenting the breasts, and correcting the concurrent breast asymmetry.

Methods

Twenty-eight patients with PE were treated from 2017 to 2021. All patients who visited our private practice were aiming to augment their breasts, correct their breast asymmetry, and improve their PE. The mean age of the patients was 25 years. In most cases, the submuscular dual-plane technique was chosen. Patients' quality of life regarding their chest wall deformity was assessed using the Single Step Questionnaire (SSQ). Subjects' quality of life regarding general self-esteem, psychosocial well-being, and physical function were assessed at initial screening and 24-month follow-up using the BREAST-Q V2 questionnaire. Also, patients filled out a pain-evaluating questionnaire concerning the first 5 postoperative days to determine the recovery of this specific technique.

Results

No complications were observed. The SSQ revealed high satisfaction (mean score=73) and significant (P = 0.001) improvement following the operation. The improvements regarding psychosocial well-being, sexual well-being, and satisfaction with the BREAST-Q were also equally high (P = 0.001). The pain was minimal during the first five postoperative days. This is the first prospective study that evaluates the quality of life using both the SSQ, the validated BREAST-Q, and the pain score when performing BA in patients with PE and breast asymmetry using breast silicone implants.

Conclusions

BA is a procedure that can give excellent results both regarding chest wall deformity and BA in PE patients.

Reliability and validity of the Chinese revised version of the pectus excavatum evaluation questionnaire in children with pectus excavatum

OBJECTIVE

This study aims to translate the Pectus Excavatum Evaluation Questionnaire(PEEQ) into Chinese, and to comprehensively assess subjective outcomes in quality of life of children with pectus excavatum.

METHODS

The PEEQ was translated from English to Chinese as according to the PRO translation guidelines. Structural validity and reliability of the questionnaire were examined by validated factor analysis and Cronbach's alpha coefficient analysis respectively.

RESULTS

The results of the validation factor analysis for the Chinese PEEQ parent's and child's questionnaires demonstrated that the fit indicators for each dimension met the required criteria. The overall Cronbach's alpha coefficient of parent's and child's questionnaires were 0.840 and 0.854. Both the item-level content validity index (I-CVI) and scale-level content validity index (S-CVI) of each sub-questionnaire were 1.

CONCLUSION

The Chinese version of the PEEQ parent's questionnaire is suitable as a proxy assessment for patients with PE, but the child's questionnaire needs further adjustments.

Non-surgical approaches to the management of chest wall deformities

Chest wall deformities in children encompass a broad spectrum of disorders but pectus excavatum and carinatum are by far the most common. Treatment varies substantially by center, and depends on patient symptoms, severity of disease, and surgeon preference. Historically, surgical approaches were the mainstay of treatment for these disease processes but new advances in non-surgical approaches have demonstrated reasonable results in select patients. These non-surgical approaches include vacuum bell therapy, autologous fat grafting and hyaluronic acid injections for pectus excavatum, and orthotic brace therapy for pectus carinatum. There is debate with regards to optimal patient selection for these non-surgical approaches, as well as other barriers including reimbursement issues. This paper will review the current non-surgical approaches to chest wall deformities available, including optimal patient selection, treatment protocols, indications, contraindications, and outcomes.

Simultaneous correction of a pectus excavatum with tubular breast deformity using a custom-made silicone implant

Pectus excavatum (PE) is one of the most common congenital deformities of the thorax and is characterized by a depressed sternum with reduction of the antero-posterior thoracic diameter. Although the majority of patients with PE have no physiologic limitations, it is often associated with psychological problems influencing the patients' quality of life. Surgical treatment options show particular variation with regard to invasiveness and morbidity of the respective procedures. Surgical treatment using a custom-made silicone implant represents a less invasive alternative for patients without further accompanying physical symptoms. This article describes the simultaneous correction of a PE combined with tubular breast deformity using this minimally invasive technique.

Update on Body Shaping and Volume Restoration: The Role of Hyaluronic Acid

After the introduction of facial aesthetic injectables with botulinum toxin (BoNt) in the first half of the 1990s and nonanimal-based hyaluronic acid (HA) fillers in 1996, the interest for minimally invasive procedures has exploded. With this background, it is not surprising that the interest for body contouring with HA has also attracted a lot of interest. The effectiveness and safety for breast augmentation, buttock augmentation and treatment for pectus excavatum has been extensively investigated and published. Generally, patient satisfaction has been high and complications low. Due to several factors such as limited duration and unfavorable cost, HA fillers have been withdrawn from the market. With the development of new HA products, it is possible that its use for body contouring will be reintroduced and popular in the future.