Background: Pectus deformities are common chest wall abnormalities, with surgical correction recommended for severe cases. Females undergoing repair may have breast implants history or seek concurrent augmentation. This retrospective study examines clinical implications of pectus repair in patients with breast implants and provides recommendations. Study Design: A retrospective review of females undergoing pectus repair at Mayo Clinic Arizona (January 1, 2010-February 1, 2025) was conducted. Outcomes and complications were analyzed in patients with and without breast implants. Results: In total, 456 females were included (447 excavatum, 7 arcuatum, and 2 carinatum; median age 32.7). Most patients (78.5%) underwent primary minimally invasive repairs (MIRPE); 6.6% primary hybrid MIRPE, 5.5% redo MIRPE, 9.4% primary/redo open and complex reconstructions. In total, 104 patients (22.8%) had a breast implants history, with 68 patients having breast implant-related procedures at the time of pectus surgery. At 12-months, cumulative incidence of infection was significantly higher in patients with implants present at the time of pectus repair versus those without (8.8% vs 1.8%; log rank, p=0.0015). A 4.9-fold increase in overall infection was seen in patients with implants indwelling or placed during pectus surgery. Deep infections were significantly more common in patients with implants (4.4%) than without (1.0%) (p=0.035). Similarly, superficial infections were more frequent in patients with implants (4.4%) than without (0.8%) (p = 0.016). At 30 days, patients with implants had higher rates of infection (p=0.032), pneumothorax (p=0.008), and hematoma (p=0.027), with no significant differences in other complications. Conclusion: Breast implants at the time of pectus repair were associated with increased risk of postoperative infection, pneumothorax, and hematoma. Removal of implants before pectus repair is recommended with delayed replacement, if desired.
Khedr et al. (2026) studied this question.