Expert Care for Pectus Carinatum
Pectus carinatum or "pigeon chest" is a condition where the breastbone and ribs protrude outward. It can appear in infants, but usually becomes noticeable during early adolescence growth spurts. It affects at least one in every 1,000 people and is more common in males than females.
Utah Pectus Program
The Utah Pectus Program at University of Utah Health is a premier center for chest wall conditions and treats hundreds of patients every year.
Our specialists provide compassionate and expert care tailored to the unique needs of children, adolescents, and young adults. We work closely with patients and their families to restore physical comfort and self-confidence.
What Causes Pectus Carinatum?
Pectus carinatum develops during growth spurts when the breastbone (sternum) and ribs push outward rather than lying flat. The exact reason why some people develop this condition is still being researched, however, several factors can contribute:
- Genetics—Pectus carinatum often runs in families, suggesting that it is passed down through genes.
- Abnormal Cartilage Growth—This condition is typically caused by an overgrowth of the cartilage that connects the ribs to the breastbone.
Pectus Carinatum Symptoms
Pectus carinatum does not usually cause physical symptoms. When symptoms do happen, they are generally mild and can be managed.
Symptoms
While many people with pectus carinatum don't have symptoms, some may experience:
- Chest Wall Tenderness—Sensitivity or discomfort in the area where the bone or cartilage protrudes.
- Occasional Pain—Aching or sharp pains in the chest, usually during physical activity or when lying face-down.
Emotional and Social Impact
The emotional impact from pectus carinatum can affect your daily life. Because the condition often becomes most apparent during adolescence, it can lead to:
- Self-consciousness or feeling uneasy about your appearance
- Impact on confidence that may affect you wanting to participate in activities like swimming or sports
Pectus Carinatum Treatment
At U of U Health, our team of pediatric surgeons and advanced providers specializes in correcting chest wall deformities. Because the chest walls of children and adolescents are still developing and flexible, most patients—approximately 95%—can be treated without surgery.
Non-Surgical Treatment
Custom chest-wall bracing is a non-invasive treatment that works similarly to orthodontics for teeth. A custom-fitted brace applies gentle, consistent pressure to the protruding area, gradually reshaping the chest wall over 12–18 months.
At first, the brace is worn for most of the day and night. As the chest wall begins to flatten, your specialist will reduce the time you need to wear a brace.
Surgical Treatment
The modified Ravitch technique is a surgical option for patients with severe deformities or those whose chest walls have become too rigid for a brace.
During surgery, the abnormal rib cartilage is carefully removed and the breastbone (sternum) is repositioned and flattened. Then, the chest is sculpted to a more natural contour.
U of U Health pediatric surgeons are experts in the modified Ravitch technique, ensuring the highest standards of safety and aesthetic results.
Chest Brace for Pectus Carinatum
If bracing is the right option for you, our team will guide you through every step of the process, from the initial fitting to the final results.
The Fitting Process
To make sure you have the best possible outcome, we create a brace specifically to your body. During your visit, we will take:
- Precise measurements to make sure the brace fits securely and comfortably
- 3-D chest scans using advanced 3D imaging technology to capture the exact contours of your chest wall
- Clinical photography so your provider can track progress and visual improvements over time
Wearing the Brace
A brace should be worn 16–18 hours a day. The more consistent you are, the sooner the chest wall will reach its ideal shape. The brace is designed to be simple and discreet and can be hidden under loose-fitting clothing.
Monitoring Your Progress
We stay closely involved throughout your treatment to make sure your treatment is working. At first, you will have appointments every three months so we can monitor and make any necessary adjustments. Most patients are able to use the same custom brace throughout their entire course of treatment.
Once the chest wall has reached the desired position, you will enter a "weaning phase." Similar to a retainer after dental braces, you will transition to wearing the brace at night to maintain the results and make sure the correction is permanent.
Make an Appointment with the Utah Pectus Program
The Utah Pectus Program at U of U Health makes it easy to schedule an appointment. You can schedule your initial evaluation directly or work with your primary care provider for a referral.
How to Schedule an Evaluation
Whether you are a new or returning patient, you have several ways to book your appointment:
- Phone—Call 801-662-2950 to make your appointment
- Online—Complete an online request form to submit your information and have a member of our team contact you.
Referrals and Insurance
We do not require a formal referral for an evaluation, but it is important to check with your insurance provider first. Some insurance plans require a referral from a primary care doctor to ensure your visits are covered.
Information for your Primary Care Provider
If your doctor is referring you, they have several options to send your information:
- Fax: 801-662-2980
- Phone: 801-662-2950
- Online: Complete our professional referral form
What to Expect at Your Appointment
At U of U Health, we want to make your first visit as informative as possible. Our specialists focus on a thorough evaluation to help choose the best care.
Preparing for Your Appointment
If you have had recent chest X-rays, CT scans, or MRIs at another facility, please bring these to your first visit. Our scheduling team can help you with this.
During your first appointment, the specialist will also need to examine the chest and take clinical photographs.
Evaluation and Diagnosis
In most cases, our pediatric specialists can diagnose pectus carinatum through a physical exam without the need for additional imaging. During the visit, you can expect:
- A Comprehensive Exam—A specialist will assess the chest wall and discuss any physical or emotional symptoms.
- A Personalized Consultation—If a diagnosis is confirmed, we will immediately discuss the most effective treatment options.
After Your Appointment
Once you have a diagnosis, the care team will create a plan especially for you.
If a specialist recommends bracing, we will review the custom bracing options available. If a specialist recommends surgery, our pediatric surgeons will guide you through the next steps for care.
Insurance Coverage for Pectus Carinatum Care
Insurance coverage for pectus carinatum care can vary between providers. We recommend reviewing your specific plan before your first visit to understand costs.
Out-of-Pocket Expenses for Braces
In most cases, correcting pectus carinatum is considered a cosmetic concern by insurance companies. This means that the cost of the custom brace is typically not covered and is considered an out-of-pocket expense.
Even though coverage is rare, we still recommend contacting your insurance provider to ask specifically about "orthotic coverage for pectus carinatum" in case your plan offers an exception.
Clinical Evaluations and Consultations
A brace may not be covered, but the appointments for care often are. U of U Health contracts with most major health insurance carriers. Your insurance plan may cover the cost of the initial evaluation, diagnostic exams, and follow-up visits with U of U Health.
Depending on your plan, you may still be responsible for standard co-payments, co-insurance, or meeting your deductible.
We recommend that you call your insurance provider and ask these questions:
- Is University of Utah Health an in-network provider for my plan?
- Does my plan cover pediatric specialty consultations for chest wall deformities?
- Are there benefits for durable medical equipment (DME) or custom orthotics (code L1320 or similar) specifically for pectus carinatum?
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