Custom Sternal Implant
Q: Dr. Eppley, I am very interested in your custom sternal implant surgery for pectus excavatum. How much would the surgery cost for a 3D computer design, compared to a silicone elastomer moulage technique? Also, what is the difference between the two?
A: To make a sternal implant in the contour treatment of precuts excavatum, the two approaches are as you have mentioned are a moulage and 3D CT scan design. In general a sternal implant designed from the patient’s 3D chest CT scan provides the most accurate implant shape based on the actual shape of the sternum and medial ribs. In contrast a moulage implant design is an external technique using the shape of the sternal depression. While not exactly mimicking the underlying bone shape it still provides a pretty good contour restoration.
I have used both techniques and I can not tell you that one is absolutely superior to the other in terms of the aesthetic result. Thus the technique I use for sternal implants is based on the patient’s geography. If they can be seen in the office I will use the moulage technique as I can make it myself. If they are geographically distant I will either use a 3D CT scan design or have the patient make their own clay or silicone elastomer moulage of the sternal depression. ( I send a silicone elastomer kit to do it)
My assistant Camille will pass along the cost of the surgery to you next week. The only difference in the cost between the two custom sternal implant techniques is the cost of the implant fabrication.
Dr. Barry Eppley