Wall Deformation Research Articles

Bi-valve braces for treatment of pectus carinatum in teenagers: impact on patients quality of life

BackgroundPectus carinatum may be a major issue for adolescent patients, as chest-wall malformations can have a negative impact on body image and induce self-esteem disorders. Bracing has become the first line treatment for adolescent patients whose anterior chest wall is still flexible. The main obstacle is the tolerability of the bracing device along with the patient’s compliance to the device. The aim of this study was to examine the quality of life of adolescent patients treated with bracing to correct pectus carinatum in our institution. From November 2021 to July 2023, 28 patients with pectus carinatum were treated with bracing therapy in our chest wall deformities unit. We used a bivalve brace, manufactured with computer-aided design. All patients were asked to answer a multiple-choice questionnaire designed to assess how bracing therapy impacts their daily life, treatment compliance, and overall satisfaction. Patients who wore the brace for at least 3 months, and at least 5 days per week and 10 h per day, are defined as compliant with the bracing protocol.ResultsThe mean age of the patients was 14 ± 1.36 years. Patients wore the brace for an average of 10.1 ± 6.9 months in the compliance group (n = 18), and 2.2 ± 2.5 months in the non-compliance group (n = 10). Our results show that compliant patients are fairly satisfied of the comfort of the brace, with a limited impact of the device on their daily activities and social life. However, non-compliant patients report the following dissatisfactions regarding the brace: higher pain scores, difficulty in breathing, and issues sleeping with the brace. The compliant patients noted a significant improvement in the appearance of their chest, and were satisfied with the appearance of their chest. The non-compliant patients did not notice any changes.ConclusionsCompliant patients treated with a bi-valve brace for pectus carinatum seem to have a good quality of life with a limited impact on their daily life and social activities. The bi-valve brace also seems to be an effective therapy in compliant patients.

Numerical investigations of GRS wall performance with tiered configurations

Geosynthetic Reinforced Soil (GRS) walls have become increasingly popular as a result of their numerous advantages. In some cases these structures are constructed in a multi-tiered configuration, which makes their behavior more complicated. Nevertheless, the response of the multi-tiered walls is insufficiently explained by the existing design manuals and literature studies. This paper investigated the performance of GRS walls with multi-tiered configurations using two-dimensional (2D) finite element numerical models. This study compares the performance of two-tiered GRS walls with simple GRS walls (single-tiered). It also examines the impact of offset distance, backfill strength properties, and reinforcement parameters (vertical spacing and reinforcement length) on horizontal deformations and reinforcement tensile loads in two-tiered GRS walls. Adopting a multi-tiered configuration for GRS walls can significantly reduce both the horizontal wall deformation and the maximum reinforcement tensile loads. Additionally, the critical offset distance found in this study is significantly smaller than that recommended by the Federal Highway Administration (FHWA) guidelines. The finite element results also demonstrate that using high-quality backfill soil can minimize interaction between lower and upper tiers. Using a uniform reinforcement length of 0.6H for both tiers significantly reduces horizontal deformation compared to the FHWA recommendation of 0.6H and 0.35H for the lower and the upper tier respectively.

Numerical investigation on ground and structure response of ancient site in complex strata caused by groundwater fluctuation and rainfall

As more and more ancient sites are discovered around the world, protecting them in situ has become a challenge due to issues such as ground settlement and masonry wall leaks caused by groundwater fluctuation or rainfall. In this study, laboratory tests, borehole tests and field high‐density resistivity detections are conducted to obtain information for numerical modelling, including design parameters. A complex three‐dimensional hydrological–mechanical coupling model is then established to investigate ground settlement and wall deformation caused by groundwater fluctuation and rainfall. The seepage simulation results for the initial state are accurately verified by high‐density resistivity imaging. Both measured data and numerical results indicate that changes in a single water head point mainly result in wall settlement. The pattern of wall deformation changes from settlement to lateral deformation with an increase in the drawdown rate of groundwater level. Furthermore, delayed rainfall and high‐intensity rainfall can increase foundation settlement and wall deformation. Settlement deformation determines the upper limit of the global deformation when wall nodes are mainly affected. In contrast, if lateral spreading dominates wall deformation, it determines the lower limit of the global deformation. This study provides reference for in situ protection and foundation reinforcement of ancient sites.

Pectus excavatum: the effect of tricuspid valve compression on cardiac function

BackgroundPectus excavatum (PE) is a common congenital chest wall deformity with various associated health concerns, including psychosocial impacts, academic challenges, and potential cardiopulmonary effects.ObjectiveThis study aimed to investigate the cardiac consequences of right atrioventricular groove compression in PE using cardiac magnetic resonance imaging.Materials and methodsA retrospective analysis was conducted on 661 patients with PE referred for evaluation. Patients were categorized into three groups based on the degree of right atrioventricular groove compression (no compression (NC), partial compression (PC), and complete compression(CC)). Chest wall indices were measured: pectus index (PI), depression index (DI), correction index (CI), and sternal torsion.ResultsThe study revealed significant differences in chest wall indices between the groups: PE, NC=4.15 ± 0.94, PC=4.93 ± 1.24, and CC=7.2 ± 4.01 (P<0.0001). Left ventricle ejection fraction (LVEF) showed no significant differences: LVEF, NC=58.72% ± 3.94, PC=58.49% ± 4.02, and CC=57.95% ± 3.92 (P=0.0984). Right ventricular ejection fraction (RVEF) demonstrated significant differences: RVEF, NC=55.2% ± 5.3, PC=53.8% ± 4.4, and CC=53.1% ± 4.8 (P≥0.0001). Notably, the tricuspid valve (TV) measurement on the four-chamber view decreased in patients with greater compression: NC=29.52 ± 4.6; PC=28.26 ± 4.8; and CC=24.74 ± 5.73 (P<0.0001).ConclusionThis study provides valuable insights into the cardiac consequences of right atrioventricular groove compression in PE and lends further evidence of mild cardiac changes due to PE.Graphical abstract

Constitutive behavior of asymmetric multi-material honeycombs with bi-level variably-thickened composite architecture

Bi-level tailoring of cellular metamaterials involving a dual design space of unit cell and elementary beam level architectures has recently gained traction for the ability to achieve extreme elastic constitutive properties along with modulating multi-functional mechanical behavior in an unprecedented way. This article proposes an efficient analytical approach for the accurate evaluation of all constitutive elastic constants of asymmetric multi-material variably-thickened hexagonal lattices by considering the combined effect of bending, stretching, and shearing deformations of cell walls along with their rigid rotation. A tri-member unit cell is conceptualized, wherein all nine constitutive constants are obtained through the mechanics under one cell wall direction and subsequent repetitive coordinate transformations. We enhance the design space of lattice metamaterials substantially here by introducing multiple exploitable dimensions such as asymmetric geometry, multi-material unit cells and variably-thickened cell walls, wherein the conventional monomaterial auxetic and non-auxetic hexagonal configurations can be analyzed as special cases along with other symmetric and asymmetric lattices such as a range of rectangular and rhombic geometries. The generic analytical approach along with extensive numerical results presented in this paper opens up new avenues for efficient optimized design of the next-generation multi-functional lattices and cellular metamaterials with highly tailored effective elastic properties.

Spinal posture, mobility, and position sense in adolescents with chest wall deformities: a comparison of pectus excavatum, pectus carinatum and healthy peers

PurposeThe study aimed to compare spinal posture, mobility, and position sense in adolescents with pectus excavatum (PE), pectus carinatum (PC), and healthy control (HC).Methods22 with PE, 22 with PC, and 21 HC were included in the study. The spinal posture (thoracic kyphosis, lumbar lordosis, pelvic tilt, thoracic, lumbar, pelvic lateral tilt angles) and mobility (thoracic, lumbar, hip/sacral, and overall, in the sagittal and frontal plane) with the spinal mouse, and spinal position sense (repositing errors) with the inclinometer were assessed.ResultsThe thoracic kyphosis angle of PE and PC was higher than in HC (p < 0.001; p = 0.001). Hip/sacral mobility in the sagittal plane was lower in the PE and PC than control, respectively (p < 0.001; p < 0.001). Overall sagittal spinal mobility (p:0.007) and hip/sacral mobility in the frontal plane (p:0.002) were lower in the PC than in HC. Overall frontal spinal mobility was lower in the PE and PC than in HC (p:0.002; p:0.014). The PE and PC repositing errors were higher (p < 0.001; p:0.014).ConclusionThe study found that adolescents with PE and PC had decreased spinal mobility, spinal alignment disorders, and a decline in spinal position sense. It is important not to overlook the spine during physical examinations of adolescents with chest wall deformities. In clinical practice, we suggest that adolescents with chest deformities should undergo a spine evaluation and be referred for physical therapy to manage spinal disorders.

The 3d response of a large-scale masonry arch bridge - part I: Performance under low and medium loading levels

Masonry arch bridges are characterised by three-dimensional (3D) behaviour when subjected to external eccentric loading (e.g., vehicle loads). The arch ring, abutments, backfill and spandrel walls may interact with each other in a complex manner, leading to a 3D mode of response that can have a significant impact on the initiation and propagation of damage. However, there is a dearth of experimental data from tests designed to investigate the 3D behaviour of masonry arch bridges, particularly under loading levels below those required to cause failure. This paper presents results from tests on a large-scale brickwork masonry arch bridge subjected to low- and mid-level static loads under laboratory conditions. Point loads of increasing magnitude were applied at different locations on the top of the backfill in order to investigate 3D response and damage accumulation. Details of the experimental setup, material characterisation, and the results obtained from static and repeated load tests at low- and mid-level load magnitudes are presented herein. Results demonstrate that the bridge exhibited a 3D mode of response under eccentric point loads. Loading at the mid-span resulted in greater deformation of the arch barrel compared to loading at the quarter- and three-quarter-span points, due to the shallower backfill depth over the crown. Under the mid-level loading, stiffness degradation was observed during the testing regime, suggesting an accumulation of damage in the bridge. Moreover, when loading was applied close to a spandrel wall, measurable out-of-plane deformation of the spandrel wall was observed, with this deformation increasing significantly as the load was increased from 150 kN to 250 kN. This results from a combination of increased lateral soil pressure and decreased shear resistance at the arch-spandrel wall interface.

The role of 3D printing in chest wall reconstruction.

Technology is advancing fast, and chest wall surgery finds particular benefit in the broader availability of three-dimensional (3D) reconstruction and printing. An increasing number of reports are being published on the use of these resources in virtual 3D reconstructions of chest walls in computed tomography (CT) scans, virtual surgeries, 3D printing of real-size models for surgical planning, practice, and education, and of note, the manufacture of customized 3D printed implants, changing the fundamental conception from a surgery that fits all, to a surgery for each patient. In this review, we explore the evidence published on simple chest wall reconstruction, including the use of 3D technology to assist in the improvement of the repair of the most frequent chest wall deformities: pectus excavatum and carinatum. Current studies are oriented to the automatization and customization of transthoracic implants, as well as education on real-size models. Next, we investigate the implementation of 3D printing in the repair of complex chest wall reconstruction, comprised of infrequent chest wall deformities such as pectus arcuatum and Poland syndrome. These malformations are very heterogeneous resulting in a high degree of improvisation during the surgical repair. In this setting, 3D technology plays a role in the standardization of a process that contemplates customization, concepts that may seem contradictory. Finally, 3D printing with biocompatible materials is rapidly becoming the first choice for the reconstruction of wide chest wall oncological resections. In this work, we review the first and most important current publications on the subject.

Cantilever piled-wall design criteria in cohesionless soil: a review

Purpose The design of cantilever pile walls (CPWs) presents several common challenges. These challenges include soil variability, groundwater conditions, complex loading conditions, construction considerations, structural integrity, uncertainties in design parameters and construction and monitoring costs. Accordingly, this paper is to provide a detailed literature review on the design criteria of CPWs, specifically in cohesionless soil. This study aims to present a comprehensive overview of the current state of knowledge in this area. Design/methodology/approach The paper uses a literature review approach to gather information on the design criteria of CPWs in cohesionless soil. It covers various aspects such as excavation support systems (ESSs), deformation behavior, design criteria, lateral earth pressure calculation theories, load distribution methods and conventional design approaches. Findings The review identifies and discusses common challenges associated with the design of CPWs in cohesionless soil. It highlights the uncertainties in determining load distribution and the potential for excessive wall deformations. The paper presents various approaches and methodologies proposed by researchers to address these challenges. Originality/value The paper contributes to the field of geotechnical engineering by providing a valuable resource for geotechnical engineers and researchers involved in the design and analysis of CPWs in cohesionless soil. It offers insights into the design criteria, challenges and potential solutions specific to CPWs in cohesionless soil, filling a gap in the existing knowledge base. The paper draws attention to the limitations of existing analytical methods that neglect the serviceability limit state and assume rigid plastic soil behavior, highlighting the need for improved design approaches in this context.

Size/Shape-Controllable Carbonized Wood Electrodes Enabled by an MXene Shell with Spatial Confinement and a Traction Effect on the Wood Cell Wall for Shape-Customizable Energy Storage Devices.

The shrinkage and collapse of wood cell walls during carbonization make it challenging to control the size and shape of carbonized wood (CW) through pre- or postprocessing (e.g., sawing, cutting, and milling). Herein, a shape-adaptive MXene shell (MS) is created on the surface of the wood cell walls. The MS limits the deformation of wood cell walls by spatial confinement and traction effects, which is supported by the inherent dimensional stability of the MS and the formation of new C-O-Ti covalent bonds between the wood cell wall and MS. Consequently, the volumetric shrinkage ratio of CW encapsulated by the MS (CW-MS) is significantly reduced from 54.8% for CW to 2.6% for CW-MS even at 800 °C. The harnessing of this collapse enables the production of CW-MS with prolonged stability and high electric conductivity (384 S m-1). These properties make CW-MS suitable for energy storage devices with various designed shapes, matching the increasingly compact and complex structures of electronic devices.

Centrifuge modelling of supported excavations using an improved in-flight excavation tool

A modified tool for simulating the entire process of supported excavation in centrifuge modelling was developed based on a Cambridge type of excavating system. Utilising the modified tool, a series of centrifuge tests of braced excavations in sand and clay soils were conducted to investigate the impacts of staged excavation on the characteristics of retaining wall displacement and ground settlement. The experimental results show that before the struts were installed, the movement of the retaining wall follows a cantilever movement pattern, in which the wall rotates about a fixed point near the toe and the maximum wall deflection occurs at the wall crest. For the strut installation process of a multi-strutted excavation, the wall deformation pattern changes to a concave profile. The maximum wall displacement in a multi-strutted excavation in sand is located slightly above the bottom of the excavation; while it is slightly below the bottom of the excavation in clay. The differences between the deformation pattern for multi-strutted excavations in sand and clay are clarified using the profiles of the ground settlement against distance from the wall. The results from this study can provide useful references for predictions of excavation-induced deformations and understanding the associated deformation mechanisms.

Surface mapping of gastric motor functions using MRI: a comparative study between humans and rats.

The stomach's ability to store, mix, propel, and empty its content requires highly coordinated motor functions. However, current diagnostic tools cannot simultaneously assess these motor processes. This study aimed to use magnetic resonance imaging (MRI) to map multifaceted gastric motor functions, including accommodation, tonic and peristaltic contractions, and emptying, through a single noninvasive experiment for both humans and rats. Ten humans and 10 Sprague-Dawley rats consumed MRI-visible semisolid meals and underwent MRI scans. We used a surface model to analyze MRI data, capturing the deformation of the stomach wall on ingestion or during digestion. We inferred muscle activity, mapped motor processes, parcellated the stomach into functional regions, and revealed cross-species distinctions. In humans, both the fundus and antrum distended postmeal, followed by sustained tonic contractions to regulate intragastric pressure. Peristaltic contractions initiated from the distal fundus, including three concurrent wavefronts oscillating at 3.3 cycles/min and traveling at 1.7 to 2.9 mm/s. These motor functions facilitated linear gastric emptying with a 61-min half-time. In contrast, rats exhibited peristalsis from the midcorpus, showing two wavefronts oscillating at 5.0 cycles/min and traveling at 0.4 to 0.9 mm/s. For both species, motility features allowed functional parcellation of the stomach along a midcorpus division. This study maps region- and species-specific gastric motor functions. We demonstrate the value of MRI with surface modeling in understanding gastric physiology and its potential to become a new standard for clinical and preclinical investigations of gastric disorders at both individual and group levels.NEW & NOTEWORTHY A novel MRI technique can visualize how the stomach accommodates, mixes, and propels food for digestion in humans and animals alike. Digital models of gastric MRI reveal the functional maps, organization, and distinction of the stomach across individuals and species. This technique holds the unique potential to advance basic and clinical studies of functional gastric disorders.

Correlation of anterior chest wall anomalies and spinal deformities: a comprehensive descriptive study.

To investigate the association and evaluate the characteristics between different types of anterior chest wall and spinal deformities. A total of 548 patients with anterior chest wall deformities were included in this study. Clinical and radiological examinations were performed to determine spinal deformities. The type and severity of the spinal deformities were evaluated and their relationships with chest wall deformity subtypes were statistically analyzed. Spinal deformities were identified in 93 (16.97%) patients. The patients were subdivided into 71 (76.3%) male and 22 (23.7%) female patients. A spinal deformity was detected in 57 (13%) of 418 pectus excavatum (PE) patients, in 23 (19%) of 117 pectus carinatum (PC) patients, and in all patients with mixed pectus deformity (PE + PC), syndromic deformity and rib anomalies. In the PE group, scoliosis, and kyphosis were observed at 57.9 and 31.6%, respectively. In the PC group, these rates were 43.5 and 47.8%, respectively. Idiopathic scoliosis was observed in 42 (77.7%) and constituted the most common scoliosis subgroup. The main thoracic curvature was the most common curve pattern, which was observed in 15 (35.7%) patients with idiopathic scoliosis. Idiopathic scoliosis with main thoracic curvature is the most common deformity in patients with anterior chest wall deformity. Spinal deformities are more common in male patients with chest deformities. Kyphosis is found in a significant number of PE and PC patients. Patients with mixed PE and PC, rib anomalies, and syndromic disease are more likely to have spinal deformities.

Buttress wall in limiting wall deformation caused by deep excavation: A case study for colluvial soil in Vietnam

The objective of this study is to assess the impact of utilizing a BW (Buttress wall) to control the deflection of a diaphragm wall in colluvial soil conditions in Vietnam. The physical and mechanical properties of the colluvial layers are evaluated using data closely monitored during a specific project, serving as validation for 3D numerical simulations utilizing the Hardening Soil Model. The analysis results closely match the field monitoring data, which has tested the accuracy of the simulation model. This forms the basis for further investigations into the dimensional parameters of BW walls, including length, thickness, and spacing between them. The results obtained from the parametric study demonstrate that altering the wall length and spacing between BWwalls significantly limits the deflection of the diaphragm wall, while changes in thickness have a negligible effect. Through the 3D numerical simulations, a linear relationship between the maximum wall deflection and parameters such as wall length and spacing between BW walls has been established.

Multi-energy field simulation and experimental research on laser composite machining of micro-holes

Thin-walled micro-holes are frequently used in aerospace components to achieve specific functions, such as heat dissipation and filtration. However, traditional manufacturing technologies face difficulties in achieving precision machining of these holes due to deformation caused by cutting force or heat. Laser machining is a highly flexible and efficient advanced processing technology that aims to achieve precise machining of thin-walled holes. However, it is important to note that the thermal energy generated by the laser can cause deformation of the thin walls. To address these issues, this paper proposes a process that combines laser and backside electrochemical composite machining. The model for laser electrochemical composite processing after through-hole formation suggests that the laser's temperature rise effect on the electrolyte can significantly enhance the efficiency of electrochemical processing. Furthermore, the laser exerts a micro-zone stirring effect on the electrolyte in the processed micro-zone, which promotes the liquid-phase mass transfer process during the electrochemical reaction. Furthermore, a one-way experiment was conducted to investigate the effects of the main laser parameters on the processing results. The results indicated that higher laser power, as well as lower laser frequency and scanning speed, significantly reduced the edge damage and pore taper of the processed micro-holes. The language used is clear, concise, and objective, adhering to a formal register and avoiding biased or ornamental language. Technical terms are consistently used and explained when first introduced. The text is grammatically correct and free from spelling and punctuation errors. Furthermore, this process has significantly reduced the oxygen content and surface roughness of the sidewalls of the micro-holes.

Characterization of deep-sea sponge ground (Asconema setubalense) using structure from motion methodology.

The hexactinellid sponge Asconema setubalenseKent, 1870 is a deep-sea species characterized by its expansive cup-shaped morphology, which contributes significantly to the three-dimensional complexity of the marine ecosystems. This sponge forms grounds that offer protection to pelagic organisms and juvenile stages. Despite its ecological relevance, there is a lack of information on the ecology, behavior and population structure of this species. The research aimed to conduct a multitemporal analysis of this sponge in the Aviles Canyon System over a ten-year period, focusing on spatial distribution and abundance. Changes in fishing pressure were estimated using the presence of fishing gears as a proxy. Additionally, the study sought to provide a detailed morphometric description through 3D photogrammetric reconstructions based on the latest data. The multi-temporal analysis revealed a subtle increase in sponge density, particularly at depths ranging from 320 to 390 m, exhibiting an irregular spatial distribution in 2022, with maximal values of 0.08 individuals/m2. Despite a small decrease on the loss of fishing gears in the overlapping area between samplings in 2012 and 2022, there was not a clear indication of a decline in fishing pressure over the years. Notably, more sightings of fishing gears were found in transect IC222TV_16 (0.07 gears/m2) than in IC222_TV02 (0.04 gears/m2) in 2022, suggesting potential spatial preferences for fishing activities. Visual analysis of temporal populations revealed an increase of 7% in specimen perturbations over ten years, with the population in IC222_TV16 being healthier (9% of the individuals presenting severe deformations) than in IC222_TV02 (40%). High-density fishing gear locations coincided with areas inhabited by sponges displaying the highest perturbation levels in both transects. Morphometric analysis using data from 2022 indicated a prevalence of individuals with heights concentrated between 0.18 and 0.38 m, osculum and flounce diameters reaching 0.4 and 0.56 m and osculum and flounce surfaces of 0.02–0.04 and 0.06–0.19 m2 respectively. Over 80% of measured specimens exhibited a high degree of asymmetry. Strong correlations were observed between heights and osculum and flounce surfaces, but external factors may be included for explaining wall deformities. These findings contribute valuable insights into the characterization of A. setubalense, serving as a foundation for future research in the area. Moreover, this work highlights the promising potential of photogrammetry as an efficient tool for monitoring of vulnerable marine ecosystems (VME) and marine protected areas.

Prevalence and incidence of chest wall deformities in children below 18 years old: The first systematic review and meta-analysis

Prevalence and incidence of chest wall deformities in children below 18 years old: The first systematic review and meta-analysis

Evaluating the web as a source of information for patients with chest wall deformities: insights into engagement and disparities.

Recent data highlight the internet's pivotal role as the primary information source for patients. In this study, we emulate a patient's/caregiver's quest for online information concerning chest deformities and assess the quality of available information. We conducted an internet search using combination of the terms "pectus excavatum," "pectus excavatum surgery," "funnel chest," "pectus excavatum repair" and identified the first 100 relevant websites from the three most popular search engines: Google, Yahoo, and Bing. These websites were evaluated using the modified Ensuring Quality Information for Patients (EQIP) instrument. Of the 300 websites generated, 140 (46.7%) were included in our evaluation after elimination of duplicates, non-English websites, and those targeting medical professionals. The EQIP scores in the final sample ranged from 8 to 32/36, with a median score of 22. Most of the evaluated websites (32.8%) originated from hospitals, yet none met all 36 EQIP criteria. None of the evaluated websites pertaining to pectus excavatum achieved a flawless "content quality" score. The diverse array of websites potentially complicates patients' efforts to navigate toward high-quality resources. Barriers in accessing high-quality online patient information may contribute to disparities in referral, patient engagement, treatment satisfaction, and overall quality of life. IV.

Effect of stiffness of building adjacent to excavation on deformation of the excavation wall

Effect of stiffness of building adjacent to excavation on deformation of the excavation wall

Can a Breast Augmentation Procedure Improve the Appearance of Pectus Excavatum Deformity in Female Patients? A Prospective Study.

This study evaluates a specific breast augmentation (BA) technique in patients with pectus excavatum(PE) and its results in improving this deformity, augmenting the breasts, and correcting the concurrent breast asymmetry. Twenty-eight patients with PE were treated from 2017 to 2021. All patients who visited our private practice were aiming to augment their breasts, correct their breast asymmetry, and improve their PE. The mean age of the patients was 25 years. In most cases, the submuscular dual-plane technique was chosen. Patients' quality of life regarding their chest wall deformity was assessed using the Single Step Questionnaire (SSQ). Subjects' quality of life regarding general self-esteem, psychosocial well-being, and physical function were assessed at initial screening and 24-month follow-up using the BREAST-Q V2 questionnaire. Also, patients filled out a pain-evaluating questionnaire concerning the first 5 postoperative days to determine the recovery of this specific technique. No complications were observed. The SSQ revealed high satisfaction (mean score=73) and significant (P = 0.001) improvement following the operation. The improvements regarding psychosocial well-being, sexual well-being, and satisfaction with the BREAST-Q were also equally high (P = 0.001). The pain was minimal during the first five postoperative days. This is the first prospective study that evaluates the quality of life using both the SSQ, the validated BREAST-Q, and the pain score when performing BA in patients with PE and breast asymmetry using breast silicone implants. BA is a procedure that can give excellent results both regarding chest wall deformity and BA in PE patients.