Chest wall deformities
Pectus excavatum and pectus carinatum: assessment and treatment.
Draft awaiting medical review · General information; not a substitute for an individual consultation and assessment.
Content updated: 22 October 2026 · Last physician review: not yet completed.
What are chest wall deformities?
In pectus excavatum, the breastbone is sunken inward; in pectus carinatum, it protrudes forward. The degree of deformity, chest wall flexibility and the person’s symptoms matter when assessing treatment. A newly appearing mass or swelling is a separate issue.
What is assessed during examination?
The assessment considers when the appearance was first noticed, changes with growth, pain and symptoms during exercise. CT, lung function tests and a cardiac assessment may be performed when needed. Decisions are not based on a photograph or a single measurement alone; symptoms and expectations also matter.
Nonsurgical options
Monitoring and posture exercises may be considered for mild deformities. Bracing under specialist supervision may suit some patients with pectus carinatum. A vacuum bell may be considered for selected pectus excavatum cases. Suitability depends on factors such as chest wall flexibility and age.
Nuss and other surgical approaches
In the Nuss procedure, a metal bar placed behind the breastbone aims to correct the depression. Open repair methods are also available. Risks include pain, infection, bar displacement and rare serious organ or vessel injuries. Bar removal requires separate planning.
Follow-up after surgery
Pain control, breathing exercises and activity plans depend on the method used. Patients with a bar need follow-up and a future removal plan. Follow the surgical team’s advice on returning to sport and heavy lifting.
Frequently asked questions
Does every sunken chest require surgery?
No. Severity, functional effects and individual circumstances are considered together.
Is bracing used for all chest deformities?
No. Bracing and vacuum bells serve different purposes; suitability requires specialist assessment.
Learn about chest wall masses →
Further reading
Patient information sources · Sources checked: 22 October 2026. Checking sources does not mean the text has been medically approved by the physician.