Breast asymmetry and pectus excavatum improvement with fat grafting

In women, pectus excavatum malformation can cause modified breast morphology, resulting in mammary asymmetry, which can be increased by placing mammary implants alone. Fat transfer can be an elegant solution to increase the volume and projection of the breast. The authors discuss their experience treating pectus excavatum with fat transfer (lipomodeling) since 2000. The charts of 19 consecutive patients with a pectus excavatum breast asymmetry who underwent lipomodeling treatment at the authors' facility between January 2000 and November 2011 were retrospectively reviewed. Patients were separated using the Chin classification (type 1, 2, and 3). Data points for each patient included age and body mass index, number of interventions and volume of fat injected during each session, total volume transferred, and postoperative complications. The clinical result was evaluated by the patient and the surgical team on a 4-point scale: very good, good, fair, or poor. Most (74%) patients in this series had type 3 Chin pectus excavatum. The average age was 28 years, and the average body mass index was 20.3. The average number of lipomodeling sessions was 1.63, and the average volume of fat transferred was 230 mL per session and 375 mL total. The patients and the surgical team were very satisfied or satisfied in 95% of cases and considered the result fair in 5% of cases. There were no complications. Fat transfer for treatment of pectus excavatum yields very good (natural and stable) results and high patient satisfaction rates, which makes this technique our preferred method for treating thoracomammary malformations in pectus excavatum.