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Jean Pierre Chavoin, Elise Lupon, Benoit Chaput, Jean Louis Grolleau, Comments on: An Open, Prospective Study to Evaluate the Effectiveness and Safety of Hyaluronic Acid for Pectus Excavatum Treatment, Aesthetic Surgery Journal, Volume 39, Issue 7, July 2019, Pages NP300–NP301, https://doi.org/10.1093/asj/sjz010
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Extract
It was with great interest that we read the article written by distinguished plastic surgeons Dr Per Hedén and Prof Raphael Sinna.1 However, an attentive reading elicited certain responses on our part. The authors reported on a short series of 23 males who had mild pectus excavatum without functional problems. The aim was to assess the impact and evaluate treatment of pectus excavatum with hyaluronic acid gel in terms of effectiveness, duration, safety, and quality of life.
Although we totally agree with the fact that the deformity is commonly associated with psychological problems and that almost all patients seek treatment primarily for cosmetic reasons, we do not agree with the authors on postoperative recovery times and the lack of documentation on surgical treatments by implants.2
With regards to criticism concerning the visible nature of implants, complications such as aesthetic defects are no longer relevant because plaster molds of the thorax have been replaced by computer-aided design with 3-dimensional computed tomographic data for the manufacture of prostheses, as well as the fact that the implant is now placed in a retropectoral position.2 On the other hand, hyaluronic acid is a filler that can be unstable on smooth, hard, deep planes. It can move and slide in a caudal ectopic position and can therefore become visible under the skin (Figure 1).
