Tratamento da ptose mamária bilateral e do pectus excavatum através da mesma incisão no mesmo tempo cirúrgico

CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem.CONTEXTO: Deformidades congênitas da parede torácica anterior são caracterizadas pelo desenvolvimento anormal das cartilagens costais. Todas essas afecções são frequentemente associadas com as mais diferentes deformidades da mama. Várias técnicas cirúrgicas têm sido utilizadas para a correção desde as esternocondroplastias até, atualmente, técnicas minimamente invasivas e próteses de silicone. RELATO DE CASO: O presente artigo relata o caso de uma paciente jovem que apresentava ptose mamária bilateral e uma forma moderada de pectus excavatum que ocasionava uma protrusão entre a oitava e a décima costelas, tendo como consequencia a desarmonia estética. O tratamento cirúrgico proposto incluiu, além de implantes mamários sub-glandulares de poliuretano, ressecção de parte da cartilagem da costela e parte do segmento ósseo da oitava, nona e décima costelas por uma única incisão sub-mamária para tornar a cicatriz minimamente visível. A correção por meio de uma única incisão beneficiou a paciente, proporcionando excelente resultado estético. CONCLUSÕES: As técnicas utilizadas para reparação da ptose mamária bilateral e do pectus excavatum pelas equipes de cirurgia plástica e torácica, respectivamente, demonstraram-se eficazes para correção de ambas as deformidades. Foi obtido ótimo resultado estético e funcional com consequente retomada da auto-estima da paciente.Universidade Católica de PelotasUniversidade Federal de PelotasUniversidade Federal de São Paulo (UNIFESP) Department of Surgery Division of Operative Technique and Experimental SurgeryUNIFESP, Department of Surgery Division of Operative Technique and Experimental SurgerySciEL

Treatment of bilateral mammary ptosis and pectus excavatum through the same incision in one surgical stage

CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem

Update on the Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guideline of the Brazilian Society of Cardiology-2019

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