Frequently Asked Questions

The surgical steel bars will remain in your chest for a minimum of 2-3 years post operation.
The best age to get the Nuss Procedure is around 13 – 16 years old when the chest’s cartilage and bones are still malleable and easier to manipulate and bend into the correct shape. Though Dr. LoSasso has completed many very successful Nuss Procedures in patients as old as 51 years old. So though it is best to get the surgery when you are younger, it is still possible to have excellent results even in adults.
Most younger patients only need 1 bar in order to correct the chest wall. However, in some older patients where the cartilage and bones have calcified and are more rigid and strong the use of a secondary bar is often required. There is usually no additional pain and the same incision is used to insert both bars, so no additional scaring is necessary.
Most patients with Pectus Excavatum experience chest pains, shortness of breathe and fatigue. If you are experiencing any of these symptoms you should definitely seek a consultation from Dr. LoSasso to see if surgery is necessary.
The Haller Index is a measurement used in order to determine the severity of your Pectus deformity. Most patients have a Haller Index of between 2-4, and in the more severe cases up to 5-6. The higher the Haller Index the more severe the depression in your chest and the closer it is to your spine. When you consult with Dr. LoSasso he will measure your Haller Index in order to determine the severity of your Pectus.
Less than 5% of patients experience recurrence of the deformity after the bar is removed.
For the vast majority of Pectus Excavatum patients the condition does not affect ones life expectancy. However, in patients with Marfan Syndrome or Marfan like conditions (1 in 500 patients with Pectus), 30% will have life threatening aortic events that can effect life expectancy.
Patients who have had the Nuss Procedure will still be able to receive CPR in the case of an emergency. However, it may be slightly more difficult for the person performing the CPR to press on the patients chest. More excessive force will more than likely need to be applied than to a person who doesn’t have surgical steel bars in their chest. Ultimately CPR will still be effective on Nuss patients and will work just fine.
The Center Of Excellence For Pectus accepts most major insurance providers, though we tend to be out of network for most HMO plans, so a PPO health plan is highly recommended. If you have any questions about your insurance coverage please don’t hesitate to call our office and one of our friendly staff will be happy to let you know if your plan covers the Nuss Procedure with us.
Dr. LoSasso has completed over 800 successful Nuss Procedures and counting.
Patients are usually kept in the hospital for around 4-6 days post operation depending upon pain level.
6 months after the surgery patients can go back to playing any sport again. It is at this time that the bar is fully integrated into the chest and you can do everything that you did prior to the surgery.
Every patient manages pain differently. We have an excellent pain management team at both Rady’s Childrens and Sharp Memorial Hospitals that will monitor your pain closely following the surgery. An epidural is used to closely manage the pain after the surgery followed by oral pain medication. Most patients feel very little pain following the surgery and are quite comfortable throughout their stay at the hospital. Once discharged from the hospital there is close monitoring of each patient regarding pain management and the specific medications and dosing are individualized to achieve optimum pain control. Over the years Dr. LoSasso in conjunction with the pain service at both Rady’s and Sharp Memorial hospitals he has created a custom pain management regime specifically designed for the Nuss Procedure which optimizes pain control.
In 1998 Dr. LoSasso heard Dr. Nuss’s original lecture about his brand new minimally invasive surgery to solve the problem with Pectus Excavatum. He then immediately flew out to train with Dr. Nuss himself in Norfolk Virginia where he trained and learned directly from Dr. Nuss all that is involved with the surgery. From the pre-operative evaluation to the intra-operative procedure as well as the post operative care. Dr. LoSasso brought his knowledge back to San Diego where he performed his first Nuss Procedure in 1999. He has been performing successful Nuss Procedures ever since.
Dr. LoSasso has successfully performed the Nuss Procedure on a number of women with breast implants and has developed a special procedure just for this case. He takes special care to avoid the implant capsules and adds a prosthetic layer over the bar to protect the breasts from making contact with the bar once in place.

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