Project Description

For most of his life, Justin Reichlin’s chest looked like someone had thrown a bowling ball at him, leaving a permanent dent.

The middle of his chest was sunken, caused by a birth defect known as pectus excavatum, and 20-year-old Justin spent his childhood and adolescence hiding the deformity under shirts.

On Tuesday, in a theatre at Sunward Hospital in Boksburg, his chest filled out as surgeons corrected the shape of his chest wall by sliding two flat bars through a 2cm-long incision in his side.

Justin was only the third patient to undergo this procedure in South Africa.

It was invented by a South African professor, Donald Nuss in the US 21 years ago, and was finally performed in his home country for the first time on Monday, when the first two patients were operated on at the Netcare Linksfield Clinic.

When Nuss initially proposed the technique, no one believed it was possible, and he received little support from the medical community.

Previously, pectus deformities had been corrected using invasive and risky open-chest surgery, which involved dislocating the breastbone from the ribs and fracturing it to turn it upside down.

It was during such a procedure that Nuss noticed how flexible the cartilage was. He then developed a technique that requires only three small incisions, and is usually performed in under an hour.

The method involves a probe with a camera to insert a concave metal bar into the patient’s chest cavity. The bar is then rotated 180 degrees to a convex shape, and is attached to the ribs.

It presses against the chest wall, reconfiguring it, and is removed after two to four years under general anaesthesia. In severe cases, up to three bars can be inserted.

Prevalence rates of pectus excavatum vary between one in 400 and one in a thousand worldwide. It is more common in males than females. In some cases it can cause pressure on the lungs, resulting in shortness of breath.

Justin’s mother, Jenny Reichlin, said doctors had told them he would outgrow it. In fact, it became more pronounced as he entered puberty.

Justin came across the Nuss technique on the Internet. He sent an e-mail to cardiothoracic surgeon Dr Ivan Schewitz, who went to Turkey earlier this year to learn how to perform the procedure.

Schewitz told Justin he was planning to introduce the technique to South Africa, and invited him to undergo the surgery.

“It was a rare opportunity,” said Justin.

The Reichlin family’s other option had been to send Justin to the US, where the procedure would have cost about R700 000.

Instead, Schewitz performed the procedure pro bono, and the Reichlins will be charged just R38 000 for hospital costs.

Their medical aid has refused to pay, claiming the procedure is cosmetic, but Schewitz disagrees. He believes the emotional damage caused by the deformity makes the procedure necessary.

After seeing her son’s new chest, Jenny said: “I can’t believe the difference, I’m very happy. I didn’t realise the change would be so instant.”

One of the other two patients who had the surgery on Monday, Njegoslav Elez (26), is a keen gym-goer, but no matter how hard he worked, his chest remained slightly concave, and that perfect body out of reach.

On Thursday he was told that the Nuss procedure would be performed in the country, On Sunday he saw the surgeon, and on Monday he went into theatre.

Yesterday, he was walking. In another couple of days he should be discharged from hospital. Three months from now he will be allowed to go back to gym, and then it’s just a matter of time before that perfect body is all his.

By Kanina Foss

Originally Published on IOL.CO.ZA