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DaddysGirl,   Thanks for your question.    I have had 3 or 4 patients through the years who developed a sternal wound infection, and required the removal of the sternum.  They all had a follow-up procedure in which a flap was placed over the sternum, containing abdominal wall muscle, and sometimes underlying omentum.  This serves to protect the chest cavity from minor contact with people and objects, that most people would encounter in daily living.   You may notice that when your father breathes in, his chest/ribs will balloon out a bit, while the flap retracts in a bit.  The opposite occurs when he breathes out.  When lifting heavy objects, people usually take a breath, then hold it and exert heavy pressure by contracting their abdominal muscles.  This should be avoided by your father as this would put extra pressure on the flap.    The walls of the cavity (ribs) will smooth out with time and should not be an issue for another tear.  In addition, the muscles of the flap will help prevent this also.    You will need to discuss all of your questions with the surgeon, especially his future restrictions and precautions.  Wearing a vest for daily activities should not be necessary.   You should also know that all of my patients lived for several years, with no further problems related to the removal of their sternums.    Best wishes.   Martin Cane, M.D.