Evaluation of fat thickness in the intramammary groove of adult female patients with pectus excavatum

• Published in: European journal of plastic surgery Vol. 45; no. 1; pp. 89 - 94
• Main Authors: Nagasao, Tomohisa, Miyanagi, Tomoki, Tamai, Motokii, Hatano, Asako, Kogure, Tetsukuni, Morotomi, Tadaaki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2022
• Subjects: Medicine; Medicine & Public Health; Original Paper; Plastic Surgery; Cartilage; Pectus excavatum; Rib; Bone; Anatomy; Nuss procedure
• ISSN: 0930-343X; 1435-0130
• DOI: 10.1007/s00238-020-01777-y

Background Pectus excavatum is the most common congenital deformity of the chest, with a frequency of one in 300 to 500 births. Twenty-five percent of pectus excavatum patients are female. Different surgical methods are used to treat female patients, depending on the degree of their thorax’s deformity. For patients with mild deformity, fat transfer alone is often used to augment their breasts and improve appearance. This study aims to evaluate the thickness of the subdermal fat of adult female patients with pectus excavatum. Methods The thickness of subdermal fat of the central regions of the chest was measured by referring to computer tomographic data of 62 adult Japanese female patients with pectus excavatum and 64 intact Japanese adult females. The pectus excavatum patients have no other comorbidities. These two groups were defined as pectus group and intact group, respectively. The two groups showed no statistically significant differences in ages, BMI, and thoracic cage width. Fat thickness was measured for each person at the levels of the clavicle, middle-height of the sternum, nipples, and inframammary fold. The data for each level were compared between the two groups. Results Fat thickness presented statistically significant differences at the levels of nipples and inframammary fold between pectus group (17.8 ± 5.2 SD mm at the nipple level; 19.2 ± 4.9 SD mm at the inframammary fold level) and intact group (8.0 ± 2.6 SD mm at the nipple level; 10.2 ± 4.3SD mm at the inframammary fold level). Fat thickness presented no statistically significant differences between the two groups at the levels of clavicle and middle-height of the sternum. Conclusions The intramammary fat of female pectus excavatum patients is thicker than that of intact adult women. Because of the thick fat, the intramammary groove can appear shallow after the depressed sternum is elevated in the correction surgery for pectus excavatum. Accordingly, the breasts can look smaller. Removal or positional transfer of intramammary fat can remedy this esthetic complication. Level of evidence: Level III, diagnostic study.