Pectus excavatum can be surgically repaired, but surgery is usually reserved for people who have moderate to severe signs and symptoms. People who have mild signs and symptoms may be helped by physical therapy. Certain exercises can improve posture and increase the degree to which the chest can expand.
Types of surgery
If you have moderate to severe pectus excavatum, your doctor may suggest surgery. The two most common types of surgeries used to correct pectus excavatum differ by the size of the incisions used:
- Larger incision. A center-of-the-chest incision allows the surgeon to view the breastbone directly. The deformed cartilage attaching the ribs to the lower breastbone is removed and the breastbone is fixed into a more normal position with surgical hardware, such as a metal strut or mesh supports. These supports are removed in six to 12 months.
- Smaller incisions. For a minimally invasive procedure, small incisions are placed on each side of the chest, under each arm. Long-handled tools and a narrow fiber-optic camera are inserted through the incisions. A curved metal bar is threaded under the depressed breastbone, to raise it into a more normal position. In some cases, more than one bar is used. The bars are removed after two years.
Most people who undergo surgery to correct pectus excavatum are happy with the change in how their chests look, no matter which procedure is used. Best results are achieved when the surgery is performed around the growth spurt at puberty, but adults also have benefitted from pectus excavatum repair.
April 26, 2014
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Nov. 21; 2013.
- Mayer OH. Pectus excavatum: Etiology and evaluation. http://www.uptodate.com/home. Accessed Nov. 21, 2013.
- Corain AG, et al. Pediatric Surgery. 7th ed. Philadelphia, Pa.: Saunders Elsevier: 2012. http://www.clinicalkey.com. Accessed Nov. 21; 2013.
- Jaroszewski DE, et al. Current management of pectus excavatum: A review and update of therapy and treatment recommendations. Journal of the American Board of Family Medicine. 2010;23:230.
- Neligan PC, et al. Plastic Surgery. 3rd ed. Philadelphia, Pa.: Elsevier; 2013. http://www.clinicalkey.com. Accessed Nov. 21; 2013.
- Mayer OH. Pectus excavatum: Treatment. http://www.uptodate.com/home. Accessed Nov. 21, 2013.
- Jaroszewski DE (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 10, 2014.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. Nov. 5, 2013.