Pectus carinatum is an uncommon birth defect in which a child's breastbone (sternum) bulges out abnormally. Sometimes the deformity isn't noticeable until after the adolescent growth spurt. For most children and teens, the main issue with pectus carinatum is the way it looks. However, some will have respiratory problems, including increased colds and asthma. Wearing a brace is an effective treatment for children and teens. Older teens and adults will usually need surgery to correct the problem.

  • Experience and expertise. Doctors at Mayo Clinic have extensive experience treating children with pectus carinatum, both with bracing and surgery.
  • Latest treatments. Most children and teens are able to benefit from a noninvasive bracing procedure that fully corrects pectus carinatum in three to six months. If surgery is needed, Mayo doctors use the latest methods of postoperative pain control to help speed recovery.
  • Team approach. At Mayo Clinic, specialists from pulmonary medicine, pediatrics, cardiology, and physical medicine and rehabilitation work with thoracic surgeons to care for children and adults who have pectus carinatum.

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Diagnosing pectus carinatum can usually be done simply by a physical examination. Imaging tests will be performed to document the extent of the problem and to prepare for surgery.

Doctors at Mayo Clinic prefer to treat pectus carinatum in children and adolescents with a customized pressure brace whenever possible.

Pressure brace

A customized brace applies continuous pressure to the chest wall to gradually reduce the deformity. You would typically wear a brace under your shirt for 16 to 18 hours a day. The brace:

  • Has two padded compression plates in the front and back of the chest, anchored by aluminum bars
  • Is held in place by adjustable straps
  • Has straps that are gradually adjusted as you grow to apply different levels of pressure to your chest

Most children require bracing for three to six months; however, some may require the treatment for several years. There are no restrictions on activities while wearing the brace. You initially will have follow-up visits with your doctor every two to six months to monitor the treatment.

Surgery

If the condition is not addressed until late teen years or adulthood, surgery will usually be required to correct the problem, since the chest cartilage is much less flexible at that point. This is a major surgery requiring up to a week's hospital stay, with follow-up appointments for a year. The surgeon will:

  • Open your chest wall and remove the sternum
  • Reshape your ribs so that they don't protrude outward
  • Flatten the sternum and replace it

Mayo anesthesiologists and pediatric surgeons use the latest methods of postoperative pain control that include delivering medications through a tube near the nerves of the chest (infusion catheter), to help speed recovery.

You will have restrictions on activities after surgery, some for up to six months.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Specialists in cardiovascular and thoracic surgery treat pectus carinatum in children and adults. Surgery on children is performed by Mayo surgeons at Phoenix Children's Hospital.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in cardiothoracic surgery treat pectus carinatum in adults.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in thoracic surgery, pediatric surgery and cardiovascular surgery treat pectus carinatum in children and adults. Children are cared for at Mayo Eugenio Litta Children's Hospital, part of Mayo Clinic Hospital, Saint Marys Campus.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Nov. 19, 2012