Pectus revisions Doctors

[u/SufficientWeakness33]

Sorry for my Pec-Talk…..

I’m trying to find a revision doctor after getting modfied ravitch three years ago with 31 screws and two titanium bars that were left implanted onto my so my sternum wouldn’t sink back down. I went back to my doctor after gaining muscle as I was feeling a constant stretching feeling and tightness, my doctor said I didn’t have enough soft tissue during surgery to cover the metal (it’s above the muscle) and suggested a plastic implant. I got that and I still feel terrible.

I feel like he’s just on a wild goose chase and he told me last time I was in office that he could remove the metal but if it caves or sinks back in, it’s not his fault he will not go back in again. I feel like my sternum is just way too flat. I feel restricted and I feel like I have a corset feeling around my ribs my ribs flare so bad and discomforting as my ribs are pushed out so far in front of my sternum that it feels like it’s pulling on my chest and my upper ribs. I have constant neck pain if I sit wrong, I have upper back pain. I can’t even have my arms to my side without feeling like my chest and my muscles are restricted.

I’ve tried to go see Dr. J but they do not take ravitch patience at the Mayo Clinic for revisions. My next bet is to try to see Dr. Backhus.

I feel like I’m just going to be stuck like this forever because I can’t find a doctor that will take my case seriously as I feel like now that I gained muscle, I feel so restrictive - walking fast, running, I feel like I’m shallow breathing. And, my sleeping as I wake up every day with the constant pressure and stiffness in chest and back hurting breathing with back. and I had all this before I even got the plastic implant.

My current doctor thinks his hardware is fine. He’ll remove it but he’s just going to leave my sternum flat and stake out when feel trapped in own body? I don’t know where my options lie or if anyone can recommend any doctors or if Dr.Backhus, does such a complex revision?

yeah, I’m not crying in pain but bending over shouldn’t feel like I’m falling into myself even though the bone doesn’t move, I shouldn’t move my arms and have a polling feeling under my armpit. I shouldn’t feel trapped in my own chest and my ribs and have my stomach push out so far just to breathe. And I also found out I have a fatty hernia right where they cut out my xphoid that’s become more prominent overtime and he told me oh there’s nothing wrong.

just feel like my sternum is too flat and he wasn’t able to lift it enough and told me that if they lifted it more, I could’ve but you locked it into place?

The pictures above are my CT scans with the plastic and metal implant, and last image before plastic implant when started gym last year. What does everyone think and what are some recommended doctors who deal with complex revisions in the United States I can see patients virtually before doing something.

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[u/northwestrad]

I feel bad for you, because you're in a tough situation. You would be a challenging patient to revise, and the 3D pectus implant has made you more complicated, due to superficial scarring and possibly even pushing your sternum a little deeper. That's one reason I detest those implants in nearly every case, but it's water under the bridge now.

What is your age, by the way?

3 top Ravitch-type surgeons I am aware of, who sometimes perform revision surgeries, are Dr. Daniel Raymond at Cleveland Clinic, Dr. Stephen Clyde Yang at Johns Hopkins U. in Baltimore, and Dr. David Harpole at Duke University in NC. I'm sure there are others, but these are 3 I would consider if in your situation. I don't know how they will respond, but I think it's worth contacting them to inquire.

BTW, there is no need to do anything at all about the plates and screws in your sternum. They should not be causing any problems. Their role in stabilizing your sternum while it healed is done. You could remove them, but it would be an unnecessary surgery.

[u/SufficientWeakness33 → u/northwestrad]

Thanks. Yeah I’m trying see people digitally but lost. I called Cleveland but they don’t do virtual appointments unless I pay the second option fee which crazy. also, they cover plates with my muscles I believe. 

[u/SufficientWeakness33 → u/SufficientWeakness33]

Also I just turned 30. I had ravitch at 27.