Q: Dr. Eppley, I am a 55 year-old male that underwent a pectus excavatum correction for a severe deformity. Although initially thrilled with the results, I have experienced a disappointing recurrence as is evidenced by the photos. I would do about anything at this point to have a normal looking chest. I am active and healthy, I box and lift weights. I take medication for high blood pressure, which is controlled, and I take synthroid for hypothyroidism. I do not smoke or drink, and aside from the scripts I am drug free. I would appreciate any and all information you may have on an injectable sternal procedure to help build it up.
A: Injectable sternoplasty is a concept that comes from injecting a moldeable bone cement into small lower sternal pectus excavatum defects. A pocket for the material was initially made through a small incision to receive the material which was molded into shape after it as placed, After having done a handful of cases, the bone cement material (which was intended for use for other skeletal issues) was withdrawn from the commercial market due to economic issues of the manufacturer. (not any material problems) That not leaves us with having to consider to use other materials that can be placed either through injection or a small incision. Fat injections remain as the best current method because it is truly injectable and is a natural material. And most everybody has some fat to donate. The biggest and well known problem with fat injections is that its survival is variable and can not be precisely predicted. This is why it is always overdone/overfilled. Other more material-assured results are injectable hydroxyapatite granules or beads. Which although very simple, safe and uses a well known biocompatible material, I have yet to do that just yet.
Dr. Barry Eppley