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La technique des implants sur mesure 3D en élastomère de silicone, permet à partir d'un scanner de combler avec précision, une malformation thoracique congénitale, qu'elle soit osseuse (pectus excavatum) ou musculaire (Syndrome de Poland) avec pour conséquence un repositionnement naturel des seins. Nous rapportons notre expérience de 25 ans chez 301 femmes (234 Pectus et 64 Poland). La correction pariétale doit être faite en première intention. Il est fréquent de devoir réaliser dans un second temps chez la femme, une plastie mammaire complémentaire notamment en présence d'une insuffisance de volume glandulaire ou d'un sein tubéreux assez fréquemment associé. Computer-aided design and manufacturing of custom-made elastomer implants leads from a CT scan to fill in with precision, a congenital chest wall congenital deformity, both bone (pectus excavatum) and muscle (Poland Syndrome), resulting in a natural repositioning of the breasts. We report our 25 years' experience in 301 women (234 Pectus + 64 Poland). Parietal correction must always be done in first intention. It is common to have to carry out a second stage in women with an additional mammaplasty especially in the presence of insufficient glandular volume or a fairly frequently associated tuberous breast. [ABSTRACT FROM AUTHOR]

Le pectus excavatum est la malformation thoracique congénitale la plus fréquente puisqu'elle affecte une personne sur 500. De nombreuses techniques chirurgicales ont été proposées : certaines peuvent être suivies de complications ou de résultats insuffisants alors même que leur utilité fonctionnelle est très controversée. Une chirurgie secondaire utilisant un implant 3D profond sur mesure, peut être une solution élégante, efficace et sûre comparée aux autres. Elle permet d'obtenir le bon résultat esthétique espéré par les patients exempts de tout contexte respiratoire ou cardio-vasculaire. Most common congenital malformation of the thorax, Pectus Excavatum affects about one in 500 people. Several surgical or medical techniques have been proposed. Some are followed by complications or insufficient results even though their constant functional value is highly controversial. Secondary surgery with a deep customized 3D elastomer implant, may be an elegant effective and safe solution compared to others; it allows a good aesthetic result expected by patients in the absence of any respiratory or cardio-vascular functional context. [ABSTRACT FROM AUTHOR]

Le pectus excavatum affecte environ une personne sur 500 : c'est la malformation du thorax la plus fréquente. Plusieurs techniques chirurgicales ou médicales ont été proposées. Certaines peuvent entraîner des complications ou des résultats insuffisants. La chirurgie secondaire du pectus excavatum par implants profonds sur mesure 3D est une solution élégante et efficace. Elle permet d'obtenir le bon résultat esthétique attendu par les patients en l'absence de contexte fonctionnel respiratoire ou cardiovasculaire. The pectus excavatum affects about one in 500 people. It is the most common malformation of the thorax. Several surgical or medical techniques have been proposed. Some are followed by complications or insufficient results. Secondary surgery with a deep customized 3D implant, may be an elegant and effective solution; it allows to obtain a good aesthetic result expected by patients in the absence of any respiratory or cardiovascular functional context. [ABSTRACT FROM AUTHOR]

Summary: Study purpose: The funnel chest or pectus excavatum (PE) is the most common congenital deformity. In women, it can be associated in some cases with breast asymmetry. It is the main cause of consultation in these patients. We report our management of this malformation by thoracic silicone prothesis modeled by computer-aided design. Materials and methods: Two correction procedures are proposed: One-stage procedure including thoracic silicone prothesis or breast implants only, or two-stage procedure by the combination of the two techniques in two steps. Results: Between 1998 and 2011, 31 patients had a PE, within 26 patients were treated for breast asymmetry associated with a PE. The average age was 23.1 years (15–39). The median follow-up was 65 months (24–86). Type I Chin was found in five cases (19%), type II in two cases (7.7%) and type III Chin was found in 19 cases (73%). Of these 26 patients, in both cases a breast augmentation with asymmetric volumes of implants (7.7%) has adequately corrected the problem. Thoracic endoprothesis was performed in 24 patients to treat the initial breast asymmetry. Twenty-one patients (87.5%) were satisfied with the final symmetry and have not required a breast augmentation. Three patients (12.5%) underwent a second surgical procedure to correct the initial breast asymmetry. Conclusions: Breasts asymmetries associated with PE can be adequately corrected using an isolated thoracic endoprothesis. Whether it remains a lack of results, perform an unilaterally or bilaterally breast augmentation in a second time is always possible. [Copyright &y& Elsevier]