PROCEDURES

REVERSE NUSS PROCEDURE

Why would this procedure be needed?

The Abraham or Reverse-Nuss procedure is done for severe cases of pectus carinatum, a chest deformity categorised by a defect in the chest that causes the breastbone to protrude from the chest. The conditions are often called pigeon chest since the bulging gives the chest a birdlike appearance.

Pectus carinatum can cause significant issues with confidence and self-esteem. Pectus carinatum can be mild, moderate or severe. For mild cases, external bracing may be considered however for more severe cases, Dr Schewitz may suggest corrective surgery, the Abraham or Reverse-Nuss procedure.


How is this procedure done?

The Abraham or Reverse-Nuss procedure is done the same way in which the Nuss procedure is done, except reversed. By making two small incisions into the chest, Dr Schewitz will place a stainless steel bar in front of the deformed breastbone and attach it to the outer edge of the ribs. The bar now runs beneath the musculature, but above the ribs, pushing down the protruding section of cartilage. This bar is then left in place to bend the breastbone back into its correct position over the next few years (usually 3 years).


What can be expected after surgery in terms of recovery?

Following a Reverse-Nuss or Abraham procedure, you will stay in the hospital for observation for the next week. Before you go home, Dr Schewitz will prescribe you pain medication and tell you how to care for your incisions in the next few weeks. In two weeks you will have a follow-up with him to ensure you are healing and recovering as you should. For the next 6 weeks, you will need to do breathing exercises to aid recovery. Dr Schewitz will advise when you may return to more vigorous physical exercise. Until then you should avoid strenuous activities and those that may cause an impact to the chest such as soccer and rugby.