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

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.