Bilateral breast reconstruction and pectus excavatum correction: a case and review of the literature

  • Toshihiko Satake
  • Mayu Muto
  • Seiko Kou
  • Jun Sugawara
  • Kazutaka Narui
  • Shinji Kobayashi
  • Takashi Ishikawa
  • Jiro Maegawa
Case Report


Pectus excavatum is a chest wall malformation characterized by anterior chest wall depression. It is often associated with hypoplastic breasts, sternal rotation, and consequent breast asymmetry. We present here the case of a 52-year-old female with pectus excavatum, a bilateral nipple-sparing mastectomy for breast cancer, and immediate autologous breast reconstruction using bilateral deep inferior epigastric perforator flaps. To correct reconstructed breast deformities and pectus excavatum depression and to enhance breast volume to treat hypoplastic breasts, three sessions of Brava-assisted fat grafting were performed. These postoperative courses were uneventful and without any complications. The patient was satisfied with the final esthetic results. There are only two case reports to perform bilateral breast reconstruction and surgical correction of pectus excavatum, which were used with both pedicle musculocutaneous flap and breast implant, with or without a sternal implant. In this study, we discuss indications and surgical options for bilateral breast reconstruction, pectus excavatum, and breast augmentation.

Level of Evidence: Level V, therapeutic study.


Pectus excavatum Breast cancer Breast reconstruction Deep inferior epigastric artery perforator flap Breast augmentation Fat grafting 


Compliance with ethical standards



Conflict of interest

Toshihiko Satake, Mayu Muto, Seiko Kou, Jun Sugawara, Kazutaka Narui, Shinji Kobayashi, Takashi Ishikawa and Jiro Maegawa declare that they have no conflicts of interest.

Ethical approval

For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from the patient before her inclusion in this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive SurgeryYokohama City University Medical CenterYokohamaJapan
  2. 2.Department of Plastic and Aesthetic SurgeryKO Clinic for AntiagingYokohamaJapan
  3. 3.Department of Plastic Surgery, Cosmetic Surgery and Skin Beauty DermatologyJUN CLINICNaganoJapan
  4. 4.Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
  5. 5.Department of Plastic and Reconstructive SurgeryKanagawa Children’s Medical CenterYokohamaJapan
  6. 6.Department of Breast SurgeryTokyo Medical University HospitalTokyoJapan
  7. 7.Department of Plastic and Reconstructive SurgeryYokohama City University HospitalYokohamaJapan

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