A “pigeon chest” or pectus Carinatum is where the sternum or breastbone pushes outward instead of being flat. This is an extreme form of the condition, maybe affecting one in 2000 people. More commonly, we see chests where the chest wall slopes outward instead of being relatively flat. The importance of this with regards to breast augmentation is ensuring that the breast implant doesn’t slide down the ribs and end up sitting under your armpit. So when we identify this in your consultation, we plan the pocket to be a medial dual plane, meaning we release more of the breast tissue of the medial edge of the muscle, which then tilts the muscle up medially, helping to direct the muscle forces inwards to maintain cleavage rather than let the implant slide down the chest wall.