Presentation of Dr. José Galbis
Hello, I am doctor José Marcelo Galbis, thoracic surgeon, President of the Foundation of the Spanish Thoracic Surgery Society. Today we are in Bilbao, at the headquarters of the 12th Congress of the Spanish Thoracic Surgery Society, where we are going to see many subjects, among them the use of prosthesis to treat sunken chest.
What is your experience of Pectus treatment?
During my residency in the 90’s, my former boss, Dr Cantó, had a lot of experience with Pectus Excavatum, so many patients were sent to Valencia. I practiced all kind of techniques with him, especially the most aggressive ones.
Then the concept of aesthetics changed over time. Before, Pectus indications were not considered and were not treated. Today, many patients are willing to get a treatment and ask for a solution.
In my opinion, there is two kind of Pectus: the ones with structural alteration and the aesthetic ones.
Structural alterations must be treated by remodeling the thorax structure with complex and difficult techniques and may require once finished an additional implant to improve the final result.
For 95% of the cases, and we see lots of them, it is barely an aesthetical issue. two years ago we were using the Nuss technique but then we started using the implant technique which gradually replaced the Nuss in our practice.
3D implants are simple. With a correct indication and an adequate therapeutic approach, it gives wonderful results.
What is your feedback regarding 3D implants?
The patients are delighted, especially concerning the minimal and maximal age of operation as you can treat patients once the thorax is developed, until the age of 40/50 yo or more.
Simple technique, good result, good product and at the end, an adequate aesthetic result answering the patients' needs. We are treating a lot of patients with complex indications that have already been operated from their pectus, but with insufficient results, so they come to see us to find a new solution.
Could you comment a specific clinical case?
We operated a 19 y/o girl who underwent another remodeling surgery when she was 10 but the sternum fell again at 14, generating a breast asymmetry.
She came to consult us and we suggested her to correct the chest deformity first and then add a breast implant. We treated her first with a 3D implant to level off the chest wall. Then we put a 200 ml breast implant on the right breast to get back the symmetry of the breast, which could not have been done without treating the thorax first.
