Pectus carinatum is an uncommon birth defect in which a child's breastbone protrudes outward 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 also have problems with shortness of breath, especially during exercise.

While surgical repair is an option for people with severe pectus carinatum, the use of a brace to help flatten the chest is the preferred treatment for children whose bones are still growing. The brace is worn up to 23 hours a day, and results can begin to be seen in just a few months.

  • Experience and expertise. Doctors at Mayo Clinic have extensive experience treating children with pectus carinatum, both with bracing and surgery. Hundreds of people with pectus carinatum are evaluated at Mayo Clinic each year.
  • Latest treatments. Bracing to help flatten the chest is a relatively new treatment for pectus carinatum. 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 pediatric surgeons to care for children and adults who have pectus carinatum.

Mayo Clinic in Rochester, Minn., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for orthopedics by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked high performing for orthopedics by U.S. News & World Report.

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A physical examination may be all that's needed to diagnose pectus carinatum. Chest X-rays can help document the extent of the problem.

In some people, pectus carinatum is so mild that treatment isn't necessary. If treatment is needed and the child's bones are still growing, your doctor will probably recommend trying a brace first. Bracing doesn't work as well in older children and adults, but surgical repair may be an option for these age groups.

Pressure brace

A padded adjustable brace can help flatten your chest gradually. This works best in children whose bones haven't stopped growing yet, because the cartilage that attaches their ribs to their breastbone is still flexible enough to be remolded by the brace.

Most children wear the brace at least 18 hours a day for three to six months. After your chest achieves the desired appearance, you may need to continue wearing the brace eight hours a day — usually while you sleep — until your bones stop growing.

Because the brace can irritate the skin, it may be best to wear a snug, moisture-wicking shirt under the brace and then your regular street clothes over the brace.

Surgery

If the condition is not addressed until late teen years or adulthood, surgery may be required to correct the problem, since the chest cartilage is much less flexible at that point.

During the surgical repair, your breastbone will be reshaped and repositioned. The cartilage that attached the ribs to the breastbone may need to be removed or reshaped. A curved metal bar might be fitted across your chest to help hold your breastbone in the proper position.

Mayo Clinic anesthesiologists and pediatric surgeons use the latest methods of postoperative pain control that include delivering medications through a flexible narrow tube inserted near the nerves of the chest to help speed recovery. You will have to limit some activities for up to six months after surgery.

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 adults.

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 pediatric surgery treat pectus carinatum in children, while specialists in thoracic surgery treat pectus carinatum in adults.

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.

May 16, 2014