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.

If the depression of your breastbone isn't causing any symptoms but you're unhappy with how it looks, you could talk to a surgeon about having a silicone insert — similar to a breast implant — placed under your skin to fill in that space.

Repair surgery

The two most common surgical procedures to repair pectus excavatum are known by the names of the surgeons who first developed them:

• Nuss procedure. This minimally invasive procedure uses small incisions placed on each side of the chest. 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.
• Ravitch technique. This older procedures involves a much larger incision down the center of the chest. The surgeon removes the deformed cartilage attaching the ribs to the lower breastbone and then fixes the breastbone 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. Although most surgeries for pectus excavatum are performed around the growth spurt at puberty, many adults also have benefitted from pectus excavatum repair.

Temporarily freezing the nerves to block pain (cryoablation) can help with recovery and decrease postoperative pain for four to six weeks.

Potential future treatments

Doctors are currently studying therapies that use suction or magnets to help raise the depressed breastbone. These devices are best used in younger patients. As people age, the chest becomes more rigid, which limits chest wall movement.