Chest Wall Implants

Chest wall implants are custom-made in 3D for conditions such as pectus excavatum and Poland syndrome. In London, each patient-specific silicone implant is designed from CT scan data to improve chest symmetry without rib modification or metal hardware, with treatment performed as a day case under TIVA. 

What Are Chest Wall Implants?

Chest wall implants are 3D custom-designed implants used to improve the appearance of chest wall irregularities, including concerns linked to and . For patients considering chest wall implants in London, this treatment can help create a more balanced and natural-looking chest contour.

The implant is placed beneath the pectoralis muscle through a small incision, helping to restore volume, symmetry, and definition where the chest wall appears sunken, uneven, or underdeveloped. The aim is to improve the shape of the chest while keeping the result in proportion with the patient’s natural anatomy.

At Centre for Surgery, chest wall implant surgery is performed under TIVA (Total Intravenous Anaesthesia) by consultant plastic surgeons on the GMC Specialist Register at the CQC-regulated Baker Street facility. A two-week cooling-off period applies after consultation, giving patients time to make a considered and confident decision about treatment.

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What is Pectus Excavatum?

Pectus excavatum — commonly known as sunken chest or funnel chest — is a congenital condition in which abnormal growth of the cartilage connecting the ribs to the sternum causes the breastbone to grow inward, creating a concave indentation in the centre of the chest.

Pectus excavatum: inward displacement of the sternum, with severity graded by the Haller index.

The degree of deformity varies from a mild dip to a deep, pronounced concavity. In the majority of cases, pectus excavatum is a cosmetic concern. In more severe cases, the inward displacement of the sternum can compress the heart and lungs, causing reduced cardiac output on exertion, exercise intolerance, and chest discomfort. Severity is measured by the Haller index — a CT-based ratio of chest dimensions — with a value above 3.25 generally considered severe.

Cosmetic vs physiological correction

Where significant cardiac or respiratory compromise is present, structural correction — the Nuss procedure (metal bar placement) or Ravitch procedure (open cartilage resection) — is the clinical standard of care. Where the primary concern is cosmetic, custom silicone implant correction provides stable improvement without structural chest wall modification. Your surgeon will assess your Haller index and clinical presentation at consultation and advise on the appropriate approach.

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What is Poland Syndrome?

Poland syndrome is a rare congenital condition characterised by underdevelopment or absence of the pectoralis major muscle on one side of the body. It affects approximately 1 in 30,000 people, is more common in males, and most frequently affects the right side.

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Poland syndrome: one-sided underdevelopment of the pectoral muscle, sometimes with rib, breast and hand involvement.

In addition to pectoralis major muscle abnormalities, Poland syndrome can involve:

Missing or underdeveloped ribs on the affected side producing asymmetric chest wall appearance.

In females, underdevelopment or absence of the breast and nipple on the affected side — requiring concurrent breast reconstruction in some cases.

Shortening of the fingers and fusion of hand bones on the same side as the affected pectoral muscle.

Underdevelopment or malformation of arm and shoulder muscles and bones on the affected side.

The exact cause of Poland syndrome is not fully understood — it is thought to involve disruption of blood flow to the subclavian artery during embryonic development. It is typically diagnosed on clinical examination; imaging (X-ray, CT, MRI) may be used to assess the extent of abnormalities.

Treatment varies by severity. For isolated pectoral muscle underdevelopment producing chest asymmetry, 3D custom-designed implants provide precise correction. More severe cases involving breast absence or significant rib abnormalities may require concurrent breast reconstruction or flap surgery.

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The 3D Custom Implant Design Process

Both pectus excavatum and Poland syndrome correction use the same fundamental 3D custom implant design and manufacturing process — producing an implant precisely matched to each patient’s chest anatomy.

A high-resolution 3D CT scan captures the precise shape, dimensions, and contours of the chest wall. For Poland syndrome, both sides are captured to allow direct comparison of the affected and unaffected sides.

The scan data is processed to segment different tissue layers — skin, fascia, muscle, and bone — creating a complete digital model of the chest anatomy.

Using the digital anatomy model, the implant is designed in CAD software. For pectus excavatum, the implant fills the concave midline defect. For Poland syndrome, the unaffected side is mirrored to design an implant that restores the missing volume and contour. Precise thickness, shape, and volume are specified to achieve a natural, symmetrical result.

A polyurethane prototype is produced from the CAD design — allowing verification of fit before the final implant is manufactured.

The final implant is cast in medical-grade silicone — biocompatible, durable, and designed to maintain its shape and structure permanently.

Benefits of Custom Chest Wall Implants

Key benefits of custom chest wall implants compared with traditional structural correction.

Every implant is manufactured from the patient’s own 3D scan data. This produces a more accurate correction than any off-the-shelf implant — the implant precisely fills the pectus defect or restores the missing pectoral volume to match the contralateral side.

Custom implant placement requires only a small incision (approximately 7 cm) and does not involve rib resection, sternum modification, or metal bar placement. This significantly reduces operating time, recovery duration, and complication profile compared to the Nuss or Ravitch procedures for pectus, or LD muscle flap transfer for Poland syndrome.

Unlike LD muscle flap reconstruction for Poland syndrome, implant correction requires no donor site surgery — no back scar, no muscle harvest, no additional recovery site.

The implant is placed beneath the pectoralis muscle — deep sub-muscular placement ensures complete tissue coverage, prevents implant movement, and produces a smooth, natural chest contour. Medical-grade silicone maintains its shape and structure permanently.

Nuss bar correction requires a second procedure for bar removal 2–3 years later. Custom silicone implant correction requires no subsequent hardware removal.

Unlike structural bone and cartilage procedures, custom implants can be adjusted or removed if clinically indicated — a flexibility not available with traditional structural correction.

The same design and surgical principles apply to both pectus excavatum and Poland syndrome — with the implant geometry differing for each condition based on the nature of the defect being corrected.

Poland Syndrome — Overview

Poland syndrome is a rare congenital condition characterised by the underdevelopment or absence of the pectoralis major muscle, which is the large chest muscle responsible for moving and stabilising the shoulder joint. The condition typically affects one side of the body, most commonly the right side, and is more prevalent in males.

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In addition to pectoralis major muscle abnormalities, Poland syndrome can also be associated with other anomalies:

Missing or underdeveloped ribs on the affected side can lead to an asymmetric chest wall appearance.

In females, there may be underdevelopment or absence of the breast and nipple on the affected side.

Shortening of the fingers and fusion of the bones in the hand, which can occur on the same side as the affected pectoralis major muscle.

There may be underdevelopment or malformation of the arm and shoulder muscles and bones on the affected side.

The exact cause of Poland syndrome is not well understood, but it is thought to involve a disruption of blood flow during embryonic development, which leads to the underdevelopment or absence of the pectoralis major muscle and associated anomalies.

Poland syndrome is typically diagnosed based on clinical examination. Imaging techniques such as X-rays, CT scans, or MRI can be used to further assess the extent of the abnormalities and to obtain the scan data required for custom implant design.

Treatment for Poland syndrome varies depending on the severity. For chest wall asymmetry from pectoral muscle absence, 3D custom-designed implants offer effective correction without the need for more invasive muscle transfer surgery. More complex cases — including breast absence in female patients or significant rib abnormalities — may require additional reconstructive procedures.

Treatment options for Poland syndrome, from custom implant correction to combined reconstruction.

Am I a Good Candidate?

Custom chest wall implant surgery is appropriate for adults with pectus excavatum or Poland syndrome causing cosmetic concern, where the deformity is sufficiently pronounced that it causes significant personal distress or practical difficulty, and where structural physiological correction is not clinically required.

Custom implant correction versus structural surgery: indications, recovery and hardware compared.

Custom implant correction is appropriate for patients where the primary indication is cosmetic rather than physiological. Patients with significant cardiac or respiratory compromise from pectus excavatum are better served by structural correction (Nuss or Ravitch procedure) — your surgeon will assess this at consultation. Implant correction is most appropriate where a well-defined concave defect can be effectively filled by a sub-muscular implant.

Custom implant correction is appropriate for patients with Poland syndrome presenting primarily with pectoral muscle underdevelopment producing chest wall volume asymmetry. Patients with additional breast absence (females), significant rib abnormalities, or hand and arm abnormalities may require additional procedures beyond implant correction alone.

Your surgeon will conduct a thorough clinical assessment at consultation — including review of relevant imaging — and advise honestly on whether custom implant correction is appropriate for your anatomy and goals, or whether additional or alternative procedures would produce a better result.

Preparing for Surgery

Once the two-week cooling-off period has passed, our pre-operative assessment team will confirm your medical fitness for surgery.

How to prepare for chest wall implant surgery in the weeks before your procedure.

Stop smoking at least 4 weeks before surgery — smoking impairs wound healing, increases infection risk, and delays recovery. Stop for at least 4 weeks after surgery too.

Stop aspirin and anti-inflammatory medications at least 2 weeks before surgery. Review all supplements with your surgeon — vitamin E, fish oil, ginkgo, and garlic all affect bleeding. Avoid alcohol for 48 hours before surgery.

No food for 6 hours before surgery; clear fluids only (water, black tea without milk, black coffee) up to 2 hours before. Your pre-operative nurse will confirm your specific fasting times.

Obtain a thoracic compression garment (compression bra or vest) in your current chest size before surgery — this is applied before discharge and worn for 2 weeks post-operatively.

What Does the Procedure Involve?

Chest wall implant surgery is performed as a day-case at our Baker Street facility under TIVA (Total Intravenous Anaesthesia) — the safest form of general anaesthesia for day-case surgery. The procedure typically takes 1.5–2.5 hours depending on the complexity of the correction.

Before surgery, your surgeon marks the planned incision site and implant position on the chest. These markings guide precise implant placement and ensure symmetry.

A single incision of approximately 7 cm is made — positioned along natural skin creases to minimise visible scarring. For pectus excavatum, this is typically a vertical midline incision. For Poland syndrome, it is positioned to provide access to the affected side pocket.

A precise pocket is created beneath the pectoralis muscle, sculpted to the exact dimensions of the custom implant. Accurate pocket sizing ensures stable implant positioning and prevents movement or displacement after surgery.

The custom silicone implant is carefully inserted and positioned to correct the deformity. Placement beneath the pectoralis muscle ensures the implant is completely covered by overlying tissue, providing a smooth, natural chest contour and preventing shifting over time.

The incision is closed in three layers using absorbable intradermal sutures — no suture removal appointment is needed. A sterile dressing is applied and a thoracic compression garment is fitted before discharge.

You recover in our monitored day suite before discharge with your responsible adult, post-operative medications, written care instructions, and a direct 24/7 clinical support number.

Recovery After Chest Wall Implant Surgery

Recovery from custom chest wall implant surgery is significantly shorter than recovery from structural chest wall procedures such as the Nuss or Ravitch procedures, or LD flap reconstruction for Poland syndrome.

Typical recovery timeline after chest wall implant surgery, from day one to three months.

Rest at home. Some swelling and bruising around the surgical site is normal. Discomfort is typically well-managed with regular paracetamol — most patients do not require stronger analgesia beyond the first 48 hours. Keep dressings in place and dry. Wear the compression garment continuously. Our nursing team calls the morning after surgery and regularly during the first two weeks.

Wound check at our clinic. Absorbable sutures only — no removal needed. Where a small seroma has developed, this is easily drained at this appointment.

Return to desk work: typically by day 7–14. Avoid strenuous upper body exercise and heavy lifting throughout. Compression garment worn for 2 weeks total. Driving resumes once comfortable performing an emergency stop.

Surgeon review. Gradual return to upper body exercise from this point.

Full return to sport and high-impact exercise. The pectoralis muscle requires approximately 3 months to fully heal and integrate around the implant. The chest contour continues to settle as swelling resolves. The scar continues to fade over 12 months.

24/7 surgeon-led clinical support for the first 48 hours. Surgeon review at 6 weeks. 3-month clinical assessment.

Risks of Chest Wall Implant Surgery

Custom chest wall implant surgery has a good safety profile compared to structural chest wall procedures. As with all surgical procedures, complications can occur. All risks are discussed in full at consultation specific to the condition and technique planned.

Risk profile for chest wall implant surgery, grouped by how commonly each occurs.

The incision is approximately 7 cm and positioned to minimise visibility. Absorbable intradermal sutures are used. Scars fade over time; silicone gel applied from 4 weeks post-operatively helps optimise scar quality.

Pectus Excavatum Before & After Results

All patients whose photographs appear below have given full written consent for the use of their images for educational purposes.

Case 1 — Pectus excavatum correction with 3D custom silicone implant. Midline concave defect filled. Chest contour restored without rib or sternum modification.

Case 2 — Custom pectus implant on table and in situ. The implant is designed from 3D CT scan data to precisely match each patient’s chest defect dimensions.

Case 3 — Pectus excavatum correction showing pre-operative deformity, custom silicone implant, and post-operative chest contour.

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Poland Syndrome Before & After Results

All patients whose photographs appear below have given full written consent for the use of their images for educational purposes.

Case 1 — Left-sided Poland syndrome. 3D custom silicone implant designed to match the right (unaffected) pectoral contour. Improved bilateral chest symmetry.

Case 2 — Poland syndrome correction showing chest asymmetry before surgery and improved bilateral symmetry after custom implant placement.

Why Choose Centre for Surgery for Chest Wall Implants?

All chest wall implant surgery at Centre for Surgery is performed by consultant plastic surgeons on the GMC Specialist Register — members of BAPRAS and ISAPS. Custom chest wall implant surgery requires specific expertise in 3D planning, implant design coordination, and precise pocket creation. Our chest wall implant programme is led by Professor Ertan Erel — FRCS(Plast), with specific expertise in complex reconstructive chest surgery. We do not use cosmetic doctors or non-specialist practitioners.

Every implant is manufactured from the patient’s own 3D scan data using CAD design and precision medical-grade silicone manufacture. No off-the-shelf sizing — each implant precisely matches each patient’s anatomy.

Pectus excavatum and Poland syndrome correction both available at Centre for Surgery, using the same design process and surgical team.

Surgery takes place at our purpose-built private hospital at 95–97 Baker Street, Marylebone, independently inspected and rated "Good" by the Care Quality Commission.

All procedures use TIVA — the safest form of general anaesthesia for day-case surgery. Faster recovery, less nausea, quicker discharge.

No overnight hospital admission. Same-day discharge following a monitored recovery period.

A mandatory two-week cooling-off period applies after every consultation.

24/7 surgeon-led support for the first 48 hours. Wound check at 7 days. Surgeon review at 6 weeks. 3-month assessment. Postoperative aftercare described as ‘outstanding’ by the CQC.

Your initial consultation is £100, redeemable against the cost of your procedure. 0% APR finance available through .

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Our purpose-built private hospital at Baker Street, Marylebone is independently regulated and inspected by the Care Quality Commission (CQC), which awarded us a Good rating — a standard very few cosmetic surgery facilities in the UK achieve. We use TIVA (Total Intravenous Anaesthesia) as standard, the safest and most advanced form of anaesthesia available for day case surgery.



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