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

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

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.

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Funding

Part of this study was funded by the Grand-in-Aid for Scientific Research (C) (18K12034) provided by the Japanese Government. Part of this study was supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C) 18 K12034.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Faculty of Medicine/Graduate School of Medicine, Kagawa University, Kida County, Miki-Cho Ikenobe, Takamatsu, Kagawa Prefecture, 1750-1, Japan

    Tomohisa Nagasao, Tomoki Miyanagi, Motokii Tamai & Tetsukuni Kogure

  2. Department of Plastic and Reconstructive Surgery, Sanno Hospital, International University of Medicine and Welfare, Tokyo, Japan

    Asako Hatano

  3. Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Kindai University, Osaka, Japan

    Tadaaki Morotomi

Authors
  1. Tomohisa Nagasao
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  2. Tomoki Miyanagi
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  3. Motokii Tamai
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  4. Asako Hatano
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  5. Tetsukuni Kogure
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  6. Tadaaki Morotomi
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Corresponding author

Correspondence to Tomohisa Nagasao.

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Conflict of interest

Tomohisa Nagasao, Tomoki Miyanagi, Motoki Tamai, Asako Hatano, Tetsukuni Kogure, and Tadaaki Morotomi have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Kagawa University approved this study (Approval #2019-138).

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Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data and photographs.

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Nagasao, T., Miyanagi, T., Tamai, M. et al. Evaluation of fat thickness in the intramammary groove of adult female patients with pectus excavatum. Eur J Plast Surg 45, 89–94 (2022). https://doi.org/10.1007/s00238-020-01777-y

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  • DOI: https://doi.org/10.1007/s00238-020-01777-y

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