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WENLIN CHEST

Causes & Symptoms Diagnosis & Procedures FAQ

Introduction

This abnormality is a rare chest wall deformity that was often mistaken for pectus carinatum in the past. In fact, it is a special type of complex deformities. Given its distinctive characteristics, Dr. Wenlin Wang named it “Wenlin Chest” to distinguish it from other complex deformities during diagnosis and treatment.

Wenlin chest is characterized by an overall thickening of the sternum, which appears as an “S” shape when viewed from the side. The most prominent protrusion is located at the sternal angle in the middle of the chest wall, where the connected rib cartilage and ribs on its both side are also elevated, forming large symmetrical protrusions on both sides of the upper chest wall. The edges of the protrusions are arc-shaped and droop downward, with a depression in the center of the chest wall. This depression is mostly a relative one, with a significant height difference from the bulges above, yet it does not cause substantive compression on the heart and lungs.

Causes

The cause of Wenlin chest remains unknown. It might be related to factors such as metabolism, nutrition, genetics, and abnormalities in embryonic development.

Symptoms

Since the depression of Wenlin chest is generally shallow, it does not severely compress the heart and lungs, and most patients do not exhibit noticeable symptoms. However, the deformity can cause significant psychological stress, leading to severe feeling of inferiority and even triggering a range of psychological issues.

Diagnostic Methods

Diagnosis primarily involves a physical examination by observing the appearance of the chest wall, supplemented by imaging examination such as X-ray, chest CT scan, and 3D reconstruction imaging.

Surgical Procedures

Wenlin procedure+Wung procedure/Wang procedure

Since Wenlin chest combines both concave and convex deformities, it cannot be treated with either of the single surgical approach used for pectus carinatum or pectus excavatum. Therefore, it requires the simultaneous performance of both surgical procedures to correct this deformity.

Frequently Asked Questions

Q: How many incisions are usually required for Wenlin Chest surgery?

Typically, 2 small incisions are made, one on each side of the chest. In some cases, an additional incision is also required in the center of the chest wall.

Q: How many bars are typically required for Wenlin Chest surgery?

In most cases, 2 bars are required. The exact number depends on the patient’s condition and the surgical plan.

Q: Does Wenlin chest improve on its own?

No, Wenlin chest does not improve spontaneously and may worsen with age. If patients experience symptoms like palpitations, shortness of breath, or chest tightness, surgical intervention is generally recommended.

Q: Does the chest wall contour change gradually after surgery, or does it improve immediately?

In most cases, the deformity is significantly corrected right after the procedure, resulting in a chest wall that appears close to normal. Following this initial correction, the chest continues a process of slight, gradual remodeling over time. The new contour is typically well-established within about 3 months and fully stabilizes after 2 to 3 years.

Q: How much does Wenlin Chest surgery cost?

The total cost usually ranges from $7,000 to $12,000. The exact amount will be determined by factors such as the patient’s condition and the specific surgical plan.

Q: Will the surgery be very painful? How does the hospital manage postoperative pain?

It is common to experience significant pain in the initial postoperative period, particularly among adolescent and adult patients due to their more rigid skeletal structure. Our hospital employs a comprehensive, multi-modal analgesia protocol to ensure effective pain control. This integrated approach includes:

Intraoperative Intervention: Intercostal nerve blocks are administered to prevent pain signals from transmitting.
Postoperative Medication: Continuous pain management is delivered through a patient-controlled analgesia (PCA) pump, supplemented with scheduled intravenous analgesics.
Adjunctive Rehabilitation Therapy: Our dedicated rehabilitation team provides personalized physiotherapy, incorporating techniques such as acupuncture, therapeutic massage, electrical stimulation, and ultrasound therapy. These modalities are highly effective in alleviating localized pain and common discomforts like postoperative bloating.

Q: How long will I need to stay in the hospital after surgery?

Most patients stay in the hospital for around 7 days, although the actual duration depends on individual recovery.

Q: Is there any risk of the bars displacing or deforming after surgery?

The risk is very low. The bars used in surgery are made of titanium alloy, which provides excellent rigidity and resistance to deformation. In addition, the Wang Technique, a cutting-edge bar fixation method, is utilized during surgery to rigidly stabilize the bars in position, effectively preventing displacement. Long-term clinical data confirms that the vast majority of patients do not experience bar displacement or deformation. It is crucial to note that during the early postoperative period (within the first 3 months), patients should avoid vigorous exercise and be mindful in their daily lives to avoid significant impact or trauma to the chest, thereby reducing the likelihood of bar displacement.

Q: Will the implanted bars affect normal physical development?

The bars may affect the normal development of the chest wall to some extent and need to be removed at the appropriate time.

Q: When can I resume my normal daily life after surgery?

Most patients can get out of bed and walk within 3–4 days after surgery, and resume daily activities around 10 days postoperatively. Patients can usually return to normal work or school (excluding heavy physical labor) around 1 month. Light exercise, such as jogging or hiking, can start within the first three months, with intensity gradually increased thereafter.

It is crucial to note that if you encounter any discomfort, such as chest pain or shortness of breath, during exercise, you should stop the activity immediately. If necessary, a chest X - ray or CT scan can be arranged for further examination.

Q: Do I need to sleep on my back after the surgery?

Yes, for the initial postoperative period, maintaining a specific sleeping position is important for healing. It is advised to sleep in a supine position (lying on your back) or a modified lateral position (partially reclining on one side) for the first month , adjusting as needed for comfort around the incision sites. Additionally, you need to avoid movements with a large range of motion, like chest expansion, bending over, and lifting heavy objects. After about a month, once your incisions have completely healed, you can gradually start sleeping on your side.

Q: When can I take a shower after surgery?

After the drainage tubes are removed (the removal time is determined by the drainage volume and follow - up examination results, generally within 1 - 2 weeks), you can take a shower with the wound covered by waterproof dressings. After finishing the shower, replace the dressings with breathable gauze to protect the wound. Around 3 weeks after surgery, once the incisions have completely healed, you can take a normal shower.

Q: What should I do if complications occur after returning to my country?

Our discharge protocol is designed to ensure your safety. Typically, patients can be safely discharged 10 - 14 days post-surgery. After about one week of observation post-discharge, the risk of the vast majority of complications can generally be excluded. If recovery progresses smoothly during the first three weeks post-surgery, the likelihood of later complications is extremely low. Additionally, the bars are firmly secured, and the surgical technique is specifically designed to prevent issues like bar displacement.

However, if you notice symptoms such as pneumothorax, pleural effusion, significant pain, or poor wound healing, please contact our doctors promptly. In case of an emergency, please seek immediate care at a local hospital.

Q: Is regular follow-up necessary? When can the bars be removed?

If your recovery goes well without any noticeable discomfort or abnormal conditions, regular follow-up is usually not required. However, if you develop symptoms such as persistent high fever (temperature >38.5°C), sudden chest tightness, shortness of breath, or difficulty breathing, please have a chest X-ray or CT scan locally and consult a thoracic surgeon or our doctor for further guidance.

The bars are usually removed three years after surgery, with the exact timing determined by the patient’s recovery and doctor’s evaluation.

Q：Can I take a flight after surgery?

Yes. Upon discharge, we will provide a discharge summary and a medical certificate. If airport security raises any concerns, presenting these medical documents will facilitate your passage.

In most cases, taking a flight does not cause discomfort, you can travel with confidence.

Q: Are there dietary restrictions after surgery? How should I supplement nutrition?

Optimal nutrition is crucial for healing. We recommend the following dietary plan, tailored to your recovery phase:

Initial Phase (during bed rest): Choose easily digestible semi-liquid foods, such as porridge, juice, or well-cooked noodles.

Recovery Phase (once able to get out of bed): Gradually resume a normal, balanced diet with an emphasis on high-quality protein sources such as fish, chicken, and eggs. Make sure to eat fresh fruits and vegetables daily to supplement vitamins and electrolytes.

Precautions: Strictly avoid spicy and greasy foods, and be cautious with foods that may trigger allergies, such as seafood or mangoes.