Introduction

Pectus excavatum, also known as “funnel chest,” is a common congenital deformity of the chest’s anterior wall. In this condition, several ribs and the sternum grow abnormally, resulting in a sunken or caved - in appearance of the chest. This deformity can have a significant impact on a patient's physical appearance, posture, breathing, and cardiac function. For those in New York City seeking to correct this condition, plastic surgery offers a viable solution. In this article, we will explore the ranking of pectus excavatum plastic surgery in New York City, along with an overview of prices and charging standards.

The ranking of pectus excavatum plastic surgery in New York City + price and charging standard overview!

Understanding Pectus Excavatum

Definition and Causes

Pectus excavatum occurs when the cartilage attached to the sternum overgrows, pushing the sternum back toward the spine. The exact cause of this overgrowth is not fully understood, but it is believed to have a genetic component. It can be present at birth or may not develop until puberty. Approximately 1 in 1000 people are affected by pectus excavatum, and it is more common in males.

Health Issues Associated with Pectus Excavatum

This deformity can lead to various health problems. As the sternum caves in, it can press on the heart and lungs. The heart may be displaced from the mid - line to the left side of the chest, which can hinder its ability to pump blood efficiently. Patients may experience fatigue during physical activity as the heart has to work harder. The lungs can also be compressed, making it more difficult to inhale and causing shortness of breath during exercise. In addition to physical symptoms, pectus excavatum can also cause psychosocial and emotional disturbances due to the visible chest deformity.

Types of Pectus Excavatum Plastic Surgery

Nuss Procedure

The Nuss procedure is considered the gold standard for treating pectus excavatum, especially in adults and children. Two small holes are made on either side of the chest, and a curved steel bar is inserted under the sternum. This bar is custom - designed for each patient to pull the sternum forward. The bar is fixed to the ribs on either side, sometimes with the help of a small, grooved plate at the end for stability. The steel bar remains in place for a minimum of two to three years, depending on the severity of the deformity. Once the sternum has adjusted to its new position, a second, less - invasive surgery is performed to remove the bar. The Nuss procedure is relatively less invasive compared to some other methods, with a shorter surgical time of about two hours in many cases. However, it can be a painful procedure, and patients typically stay in the hospital for a few days after the surgery. According to the University of California San Francisco, most children will stay up to five days in the hospital, and an epidural catheter may be placed in the back to administer continuous pain medication for several days.

Ravitch Procedure

The Ravitch procedure involves making an extended cut across the mid - chest. During this operation, the abnormal cartilage is removed, allowing the sternum to move forward. The rib cage is repositioned, and a wedge bone graft may be implanted to correct the deformity. Two titanium rods are placed in the chest area, below the sternum, to support the rib cage. These rods are screwed to the ribs on the opposite side, which helps to elevate the breastbone. The rods are removed after about three years through another surgery. This procedure can take up to six hours to complete and may require a longer hospital stay and recovery period compared to the Nuss procedure. Recently, the Ravitch technique has been revised as a less - invasive procedure in some cases.

Plastic Surgery with Implants

Silicone Implants: This is a popular plastic surgery option for patients without pulmonary and cardiac impairments caused by the deformity. A silicone implant, a biomaterial well - accepted by human tissue, is inserted directly underneath the skin through a small incision into the indented area. It is mainly used for cosmetic purposes, especially on adult or teenage patients who are self - conscious about their appearance. However, this procedure may have some long - term problems such as material abrasion, late development of seroma, dense calcification, unpleasant skin volume, and pain in the surgery area. The cost of a pectus excavatum implant can start at about $3,800 according to the American Society of Plastic Surgeons, which is considerably less than a standard Nuss procedure costing around $40,000.
Fat Grafting: Fat is transferred from one area of the body, typically the stomach, legs, or waistline, to the sunken breastbone area using injection. The main advantage is that it causes no surgical trauma or noticeable scars. However, it is not widely used for pectus excavatum correction because most patients with this condition are skinny and do not have a sufficient amount of transferrable fat. Also, the chest area's skin is tightly hugged to the breastbone, which can lead to bad results.
Macrolane: Macrolane, also known as hyaluronic acid, is a body contour filler. It has been used in plastic surgery for face wrinkle therapy. Surgeons can use it to improve the pectus excavatum condition. However, a large volume of Macrolane is needed to “fill” a sunken chest, which makes it very costly. Additionally, the result is impermanent as the filler will be resorbed, and the dent may return to its original state after about two years.
Brava - Breast Augmentation & Shaping System: This technique is designed for breast reconstruction and enlargement. It works as an outer tissue expander to create edema and boost blood perfusion. Studies have shown that when combined with vacuum device therapy, minimally invasive plastic procedures like the Brava technique can yield excellent results in the presternal area without leaving permanent ugly scars.
Tissue Engineering: Repairing a mild pectus excavatum deformity using needle transplantation of cultured autologous chondrocytes is a promising but currently under - investigation technique. It is a unique topic in breast enlargement surgery.

Ranking of Pectus Excavatum Plastic Surgery in New York City

Factors Affecting the Ranking

Surgeon Experience: Surgeons with extensive experience in performing pectus excavatum plastic surgery are highly ranked. Experienced surgeons are more likely to have encountered a variety of cases and can handle complications more effectively. For example, a surgeon who has performed hundreds of Nuss or Ravitch procedures will be more familiar with the intricacies of the operations and may achieve better outcomes.
Success Rate: The success rate of the surgeries is a crucial factor. A high success rate indicates that the surgeon and the medical facility are capable of delivering positive results. Success can be measured in terms of the correction of the chest deformity, improvement in the patient's physical health (such as better breathing and cardiac function), and patient satisfaction.
Patient Reviews: Word - of - mouth and online patient reviews play an important role in the ranking. Patients' experiences regarding the surgical process, post - operative care, and overall results can influence the reputation of a surgeon or a clinic. Positive reviews can attract more patients, while negative reviews can have the opposite effect.
Technological Advancements: Clinics that are equipped with the latest surgical technologies and tools are often ranked higher. For instance, the use of 3D reconstructive technologies in designing implants for pectus excavatum plastic surgery can lead to more accurate and personalized results.

Top - Ranked Clinics and Surgeons in New York City

Although specific rankings may change over time, some well - known clinics in New York City for pectus excavatum plastic surgery are likely to focus on providing high - quality care. Many of the top - ranked surgeons in the city have trained at prestigious medical institutions and have a track record of successful surgeries. They may also be affiliated with leading hospitals, which can offer access to advanced diagnostic and treatment facilities. Some surgeons may specialize in certain types of procedures, such as the Nuss procedure or plastic surgery with implants, and their expertise in these areas can contribute to their high ranking.

Price and Charging Standard Overview

Surgery - Only Costs

Nuss Procedure: Without health insurance, the average cost of the Nuss procedure alone ranges from $15,000 to $45,000 or more. However, longer hospital stays or more complex cases could push the cost close to the six - figure mark. According to some reports, a person in Texas without insurance who had a severe deformity paid a total bill of $61,158 for the Nuss procedure, which included costs for apothecary, surgery materials, ECG, surgery room, operation, anesthesia, chemistry laboratory, x - rays, physical exercising/recovery, and pulmonary activity. In general, insurance coverage for the Nuss procedure can vary. Some insurance companies may cover it if they deem it medically necessary, while others may consider it a cosmetic procedure and not provide coverage.
Ravitch Procedure: The cost of the Ravitch procedure typically ranges from $35,000 to $75,000 without insurance. Similar to the Nuss procedure, the final cost depends on the severity of the deformity, the length of the hospital stay, and other factors. Patients may need to be admitted to the hospital twice for this procedure, spending 2 - 3 days at a time.
Plastic Surgery with Implants: The cost of pectus excavatum implants can vary widely depending on the type of implant. As mentioned earlier, silicone implants can start at about $3,800. However, custom - designed implants using advanced technologies such as CT scans or 3D surface digital scanners can be much more expensive. Fat grafting, if feasible, may have costs associated with liposuction and injection procedures, while Macrolane treatment can be costly due to the large volume of filler required.

Extra Costs

Pre - operative Tests: A number of tests are required before pectus excavatum surgery. These may include CT/MRI scans, consultations, a pulmonary function test, a metal allergy test, and a heart sonogram. The cost of these tests can reach well into the thousands of dollars, especially if multiple advanced imaging studies are needed.
Anesthesiologist and Surgeon Fees: Separate fees are charged by the anesthesiologist and the surgeon. These fees are based on their experience, the complexity of the surgery, and the length of the operation. For example, a highly experienced surgeon may charge a higher fee compared to a less - experienced one.
Hospital Stay: The cost of the hospital stay is a significant part of the overall expense. This includes room and board, nursing care, and the use of hospital facilities. The length of the hospital stay can vary depending on the type of surgery and the patient's recovery. For instance, after the Nuss procedure, patients may stay in the hospital for 5 - 7 days, while the Ravitch procedure may require a longer stay.
Prescription Medication: After the surgery, patients will be prescribed medication for pain management and to prevent infection. Without insurance, the cost of these medications can be more than $1,000.
Physical Therapy: Physical therapy is necessary for a proper recovery after pectus excavatum surgery. Sessions can cost more than $100 each without insurance. Patients may need to attend multiple sessions over a period of several months.
Implant Removal: If metal bars or rods are inserted during the surgery, a second procedure will be required to remove them after a certain period (usually 2 - 3 years). This outpatient procedure also has associated costs, including the surgeon's fee, anesthesia, and any necessary post - operative care.

Ways to Save Money

Insurance Coverage: Check with your health insurance provider to see if they cover pectus excavatum surgery. Some insurance companies may cover the procedure if it is deemed medically necessary, especially if the deformity is causing significant heart or lung problems. It is important to understand the terms and conditions of your insurance policy and to provide all the necessary medical documentation to support your claim.
Negotiation: If you do not have insurance or your insurance does not cover the full cost, you can try to negotiate with the hospital or the surgeon. Some hospitals may offer a cash discount or a low - interest finance plan. You can also discuss the cost breakdown with the finance department to see if there are any areas where the cost can be reduced.
Medical Tourism: For some patients, traveling abroad for surgery can be a more cost - effective option. In countries like India, the cost of the Nuss procedure can range from $3,400 to $15,000. However, it is important to consider the quality of medical care, the reputation of the medical facility, and the potential challenges of traveling for surgery.

Conclusion

Pectus excavatum plastic surgery in New York City offers hope for those looking to correct this congenital chest deformity. The ranking of surgeons and clinics is based on various factors such as experience, success rate, patient reviews, and technological advancements. Understanding the different types of surgeries, their associated costs, and the extra expenses involved is crucial for patients considering this treatment. By being informed about the price and charging standards, patients can make more appropriate decisions regarding their treatment.

If you or someone you know is considering pectus excavatum plastic surgery, it is recommended to consult with multiple surgeons in New York City. Get detailed quotes, understand the surgical process, and ask about insurance coverage. You can also reach out to patient support groups or online communities to learn from the experiences of others who have undergone similar surgeries. Don't hesitate to take the next step in improving your quality of life and physical appearance.