Implant for a funnel chest

In the case of a slightly pronounced funnel chest, which does not restrict the health of the affected person, the sunken chest wall can be covered by an implant. However, an operation is necessary for this. The implant, which is specially made to fit exactly into the sunken area of the chest wall, is placed under the muscles through an approx.

7 cm incision. In addition to an implant, muscles or fat can also be transplanted. Since this method is only used for cosmetically problematic funnel chest, this treatment method is usually not paid for by the health insurance companies but by the patients themselves.

Suction cup

A relatively new (since 2002) method of treating a funnel chest is the suction bell. Various studies are currently underway to examine the effectiveness of the suction bell. With the help of a negative pressure created by the suction bell, the chest should be slowly lifted.

To achieve this, the suction cup must be used regularly for one hour every day for a period of two to three years. The hope of the users and the manufacturer is that the suction cup will make surgical treatment of the funnel chest unnecessary in the future. Up to now, the regular use of the suction cup has been described as an improvement of funnel-related postural deformities such as hunched backs or postural blockages, tightness, heartburn or funnel-related hiccups.

The advantage of its use is that the suction cup can also be used in everyday life and at home and that the presence of a doctor is not necessarily required. The treatment may cause slight pain, especially in the initial stages, but this is not comparable to the pain after an operation. According to reports so far, not only children but also middle-aged adults benefit from the suction cup. However, long-term results are still pending.

Operation of the funnel chest

In rare cases the funnel chest may cause functional impairment of lung function or heart function. In this case, an operation of the funnel chest is indicated in any case. In most cases the funnel chest is corrected surgically for cosmetic reasons.

Basically, the aim of the operation is to mechanically lift the breastbone and fix it in the corrected position. Funnel chest surgery is usually performed under general anesthesia and with epidural catheter anesthesia (for postoperative pain relief). Mainly a minimally invasive procedure (“keyhole technique”) is chosen, for which only small skin incisions are required.

To correct the funnel chest, a U-shaped bow is inserted under the funnel base of the sternum. The sternum is then lifted by a 180° rotation of the bow forward. In rare cases, an open operation is still performed: This involves cutting the cartilage connections between the sternum and the ribs and then fixing the sternum in the correct position with the aid of splints.

A plastic correction of the funnel chest with silicone implants can also be performed. In this case, the funnel is not lifted, but only compensated by a silicone implant under the skin. Before the operation, an X-ray of the breast is taken, which measures the minimum distance between the back surface of the sternum and the front edge of the vertebral bodies.

Wound healing disorders, the development of a pneumothorax (air gets into the lung gap and breathing is hindered), infections of the wounds or of the foreign material introduced, as well as severe pain after the operation are risks associated with funnel chest surgery. Rotational movements of the upper body against the trunk must be avoided for about three months after the operation, intensive physiotherapy is also necessary. The rod is removed at the earliest three years after the operation and again under general anesthesia.

Only small skin incisions are required for the minimally invasive surgery, which has cosmetic advantages. With the help of a thoracoscopy, U-shaped stirrups are inserted under the sternum (lat. sternum) while the patient is still visible.

A 180° rotation of the bow lifts the sternum outwards. There are several variants for open surgery of the funnel chest. In all variants, the cartilage connection between the ribs and the sternum is first cut and the sternum is lifted upwards.In one procedure, after loosening the cartilage, a steel splint is pushed under the funnel base to fix the sternum lifted forward.

Another option is the procedure that inserts special funnel chest rails into the ribs to fix the sternum. The sternum can also be fixed by muscle sutures alone. There is also a cosmetic solution that may only be used for cosmetic correction but not for functional complaints.

A silicone implant inserted under the skin can compensate for the funnel chest. Long-term prognoses could show that the minimally invasive procedure has an equally good functional and better cosmetic result, so that the minimally invasive procedure is preferred in clinics. Before the operation some preparations have to be made.

These include: the smallest distance between the back of the sternum and the front edge of the vertebral body is measured. In addition, this may depend on the symptoms.

A blood sample
A resting ECG
A lung function analysis
An x-ray of the chest from the front and from the side.
Exercise ECG
An echocardiography
An allergy test or
A CT can be made.

As with other operations, there are certain risks involved in funnel chest surgery.

The following symptoms may occur after the surgical procedure: The individual symptoms must only be recognized early so that one can act accordingly.

Severe pain,
Wound healing disorders,
Wound infections,
Bleeding.

An important point of the funnel chest surgery is the aftercare. A suitable pain therapy must be guaranteed.

Shortly after the operation, another X-ray should be taken in two planes, front and side. The correct position of the rods as well as the corrected funnel chest angle will be evaluated. On the 10th day after surgery, the stitches can be removed, provided the sutures have healed well.

The patient can leave the hospital on the day the stitches are removed if he/she is free of complaints or has few symptoms. An outpatient X-ray checkup should be performed two weeks after discharge, 4 weeks after discharge and then at three-monthly intervals. The patient must also take care not to perform any rotating movements for the next three months.

After the first four weeks after the surgery, the physical strain can slowly be built up. Contact sports such as soccer, basketball or judo are prohibited during the time when foreign material is in the chest. The bars or stirrups can be removed at the earliest three years after the funnel chest surgery. The removal is again performed under general anesthesia. The old sutures are reopened for this purpose and the rod or bow is loosened and removed with a rotating movement.