Hello, my name is Ludovic Fournel, I am a lecturer at Cochin Hospital in Paris, and I am a thoracic surgeon.
Can you tell us about your experience with Pectus Excavatum?
I have been a certified thoracic surgeon for over eleven years. I primarily focus on the lungs but also treat chest wall deformities, particularly pectus excavatum. We offer different types of reconstruction, covering the full spectrum of possible interventions. We can reshape the sternum and ribs to give the sternum a flatter shape.
We also use the Nuss technique, which involves inserting a bar under the sternum to reduce its curvature. Finally, we use custom-made implants, which allow us to restore a completely normal appearance to the chest wall and sternum.
What is your feedback on the use of 3D implants?
The use of 3D implants has been very satisfactory in several ways, especially in terms of aesthetics results but also in the major psychosocial impact for patients. This approach allows us to manage this condition within the public hospital system. Our experience over several years of placing custom made implants has been very positive.
However, this type of intervention is not suitable for all conditions or deformities. Specifically, it is not appropriate for cases with functional impacts on breathing or heart rhythm. On the other hand, for patients whose pathology has a psychosocial impact without functional consequences, this technique is a much less invasive alternative.
What are the advantages of custom implants compared to other existing techniques?
The major advantage of the custom implants technique is that they are much less invasive, less burdensome, and less painful than other techniques. Traditional methods, such as the Nuss technique or Ravitch procedure, are very invasive and require prolonged hospitalization, including the placement of drains and significant postoperative pain.
In contrast, custom implants allow quicker post op management and an easier recovery.
What is the functional impact of thoracic deformities on patients?
The functional impact varies depending on the severity and asymmetry of the deformity. Symptoms of a severe deformity can lead to respiratory restriction, which can be measured through pulmonary function tests.
However, most patients with a funnel chest do not experience functional repercussions on their lungs or heart.
What is the psychological impact of thoracic deformities?
The psychological impact is very significant, especially in young patients. These deformities can affect their self-confidence, social life, and even career choices. It is therefore legitimate to offer corrective solutions, even if the functional impact is minimal.
Can you share a significant clinical case?
A case I have in mind is the one of a female patient suffering from breast asymmetry caused by a low pectus arcuatum. By placing a custom implant, we corrected not only the sternal deformity but also the asymmetry of the breast.
The result was very satisfying for this woman, providing excellent aesthetic results and a real improvement in her well-being.
What advice would you give to patients affected by these conditions?
One should never rush into a decision. Take the time to thoroughly investigate the different available techniques, consult multiple specialists, and seek information from resources like AnatomikModeling.com, which offers many explanations and patient testimonials.
On average, it takes about four to five months between the first consultation and the implantation procedure. It is never an emergency, and careful consideration is necessary to choose the best solution.
Conclusion
Thoracic wall deformities now benefit from a multidisciplinary approach involving thoracic and plastic surgeons. With technological advances, especially custom implants, we can offer less invasive, effective, and patient-adapted solutions. It is essential to take the time to choose the best option in consultation with qualified professionals.
