Imagine you’ve just been told you need heart surgery. For many people, the first question is, “Does that mean you’re going to crack my chest open?” I hear that question almost every day.

For decades, the traditional sternotomy has developed a reputation for large incisions, severe pain, long hospital stays, and difficult recoveries. The reality is very different today. While minimally invasive heart surgery has advanced tremendously, traditional sternotomy has evolved just as dramatically.

For many complex valve operations and repeat heart surgeries, a sternotomy remains the safest and most effective approach because it provides the exposure needed to perform these procedures with the highest level of precision. Most importantly, choosing a sternotomy does not mean you should expect an extremely painful recovery.

Over the years, I’ve refined every aspect of how I perform these operations with one goal in mind: helping patients recover faster and more comfortably. My incisions are typically much smaller than many patients expect. I personally perform every step of every operation, from the initial incision through the final skin closure, allowing me to tailor each incision while maintaining excellent surgical exposure.

We’ve also changed how the chest is opened. Modern retractors are much more refined than those used decades ago, and I focus on gentle exposure using only the amount of opening necessary. This greatly reduces injury to surrounding cartilage and ribs.

Pain management has improved significantly as well. I routinely inject long-acting local anesthetics around the incision, similar to the numbing medicine used by dentists. I also utilize cryoablation of the intercostal nerves, a technique that temporarily freezes the nerves responsible for much of the postoperative pain. In my experience, this has become another valuable tool in helping patients recover with significantly less discomfort.