Q: Dr. Eppley, I have a cosmetic issue with one side of my chest. My right pectoral bone/cartilage formation is good but my left inner pec seems to be either missing the inner bone or it may be indented like a minor pectus excavatum. What are my options for fixing this cosmetuc chest issue. I have attached a picture so you can see the area I am referring to.
A: Thank you for sending your picture. I do think it is a very minor manifestation of a pectus excavatum. I think given its very minor cosmetic issue and its location, I would only an injectable sternoplasty technique. One option is fat injections which can be precisely placed and are not a foreign material. While its volumetric survival can not be assured and there certainly is a question of whether you have any fat to donate at all, but that would be my first choice. (although lack of a donor site may make it not an option) The other reasonable option would be injecting hydroxyapatite (HA) granules onto the sternum. These granules can be mixed with PRP (platelet-rich plasma) to form an injectable gel that can be molded once placed into the defect area.
Dr. Barry Eppley
Indianapolis, Indiana