Treatment

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 and whether or not cartilage is removed:

  • 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 or three years.
  • 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.

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.

Aug. 16, 2017
References
  1. Kliegman RM, et al. Skeletal diseases influencing pulmonary function. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Jan. 18, 2017.
  2. Mayer OH. Pectus excavatum: Etiology and evaluation. http://www.uptodate.com/home. Accessed Jan. 18, 2017.
  3. AskMayoExpert. Pectus excavatum. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  4. Holcomb GW, et al. Congenital chest wall deformities. In: Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, Pa.: Elsevier; 2014. http://www.clinicalkey.com. Accessed Jan. 18, 2017.
  5. Mayer OH. Pectus excavatum: Treatment. http://www.uptodate.com/home. Accessed Jan. 18, 2017.
  6. Jaroszewski DE, et al. Success of minimally invasive pectus excavatum procedures (modified Nuss) in adult patients. Annals of Thoracic Surgery. 2016;102:993.
  7. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Jan. 30, 2017.
  8. Jaroszewski DE (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. Feb. 12, 2017.