Expert Care for Pectus Excavatum
Pectus excavatum (sunken chest) is a condition where the breastbone grows inward, creating a dent in the chest. Sometimes called "funnel chest," this occurs when the breastbone (sternum) and ribcage grow asymmetrically. While it is often present at birth, the indentation typically becomes more noticeable during puberty growth spurts.
Fast Facts
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Prevalence—Pectus excavatum affects approximately 1 in 200 people.
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Demographics—Pectus excavatum is three times more common in males than females.
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Pectus Excavatum vs. Carinatum—While pecus excavatum creates a sunken appearance, pectus carinatum (or "pigeon chest") causes the breastbone to protrude outward.
Is Pectus Excavatum Dangerous?
Pectus excavatum is not life-threatening, but it can impact quality of life. In some cases, the inward pressure on the chest can:
- Affect how well your lungs expand during exercise
- Make you become easily tired during exercise
- Affect confidence about your appearance
What Causes Pectus Excavatum?
Doctors don't know exactly what causes pectus excavatum. The condition develops when the ribs and breastbone grow in a way that causes the chest to sink inward. This irregular growth creates the characteristic inward depression of the chest wall.
Is Pectus Excavatum Genetic?
A genetic cause has not yet been identified as the cause of pectus excavatum, but there is a strong link to family medical history. Approximately 40% of patients with chest wall conditions have one or more family members with the same condition.
Pectus Excavatum Research
Experts continue to study chest wall conditions to better understand why they occur and how they are passed down.
Pectus Excavatum Symptoms
The main symptom of pectus excavatum is an indentation in the front of the chest. For many people, this cosmetic change is the only noticeable sign of the condition.
How Pectus Excavatum Can Affect the Body
In some cases, the inward curvature of the breastbone can restrict the space available for the heart and lungs to function at full capacity. This may lead to physical symptoms, particularly during exertion or high levels of activity:
- Feeling tired or winded during physical activity
- Shortness of breath
- A rapid or irregular heartbeat (palpitations)
- Chest tightness
What to Know
If you are diagnosed with Pectus Excavatum, there are some important things to consider:
- It is a common misconception that a deeper indentation leads to more severe symptoms. The shape of the chest doesn't always show how severe the condition is.
- There is no difference in how symptoms show between males and females.
- Some people have symptoms, while others do not.
How is Pectus Excavatum Diagnosed?
A pectus specialist can often diagnosis of pectus excavatum during a comprehensive physical exam. Your doctor may recommend imaging tests to see how pectus excavatum affects your chest, heart, and lungs:
- CT Scan—Shows detailed images of the chest and helps doctors measure how deep the indentation is.
- Echocardiogram—An ultrasound used to check the heart structure and make sure it is is functioning properly inside your chest cavity.
Other Tests You May Need
If a patient is experiencing physical symptoms, such as shortness of breath or fatigue, additional tests may be ordered to assess the functional impact of the deformity:
- Electrocardiogram (EKG) to monitor the heart’s electrical activity and rhythm
- Pulmonary Function Tests (PFTs) to measure lung volume and how well the lungs move air
- Cardiopulmonary Exercise Test (CPET) to check how the heart and lungs respond together during physical exertion
Hear From Katie Russell, MD, and Brock, a Former Patient
Pectus Excavatum Treatment
The Utah Pectus Program at University of Utah Health provides personalized treatment plans based on your age, bone flexibility, and other factors. Deciding whether to have surgery is an important decision. Our pectus specialists work closely with you to weigh the benefits of correction against the recovery process.
Non-Surgery Options
For young children whose chest walls are still very flexible, Vacuum Bell Therapy may be an option. This non-invasive approach uses a specialized device to gradually lift the breastbone over time. It is often recommended for patients who are not yet candidates for surgery.
Surgery Options
While many people live healthy, active lives without treatment, surgery is an effective option for those experiencing physical symptoms or body image concerns.
The best time for surgical options is typically during early adolescence. At this stage, the chest wall is mature enough to support the correction but still flexible enough to be reshaped.
Nuss Procedure
The Nuss procedure is the standard of care for most patients. This is a minimally-invasive surgery where a surgeon makes two small incisions on the sides of the chest to insert custom-contoured metal bars behind the breastbone. These bars act as a temporary scaffold to correct the depression.
The bars usually stay in place for about three years while the chest gradually changes shape. Once the chest has healed and keeps its new shape, the bars are removed during a simple outpatient surgery.
Open Surgery (Modified Thoracic Reconstruction)
Modified Thoracic Reconstruction is an "open" approach and is for complex or mixed chest wall deformities, like pectus arcuatum. This procedure involves a large incision to allow the surgeon to reshape the cartilage and breastbone using implanted plates and bars.
What is the Nuss Procedure?
Pectus Excavatum Surgery Recovery
Managing Pain After Surgery
To help you recovery, our surgeons use an advanced technique called intercostal nerve cryoablation. During surgery, doctors can temporarily numb nerves in the chest wall to help control pain afterward. This can help reduce pain after surgery and decrease the need for heavy pain medications. Patients often experience a smoother, more manageable healing process.
What to Expect During Recovery
Most patients can return to school or work within 1–2 weeks, once they feel comfortable and their fatigue is gone. One of the benefits of our surgery technique is that there are generally no activity restrictions. Walking and light activity can help you recover. Most patients are ready to participate in their usual activities after 4–6 weeks.
While some discomfort is a natural part of the healing process, your care team is dedicated to supporting you through every milestone of recovery, making sure you have the resources you need for a successful transition back to everyday life.
After Surgery Instructions | Instrucciones Para Después de la Cirugía
Why Choose University of Utah Health?
At the Utah Pectus Program, our specialists treat hundreds of patients with pectus excavatum every year, making us a regional leader in chest wall correction. When you choose University of Utah Health, you benefit from a surgical team with deep expertise and a commitment to patient-centered innovation.
Accelerate Recovery
Get back to your daily life faster with streamlined clinical pathways.
Minimize Pain
Significantly reduce the need for narcotics through modern pain management protocols.
Shorten Hospital Stays
Spend less time in the hospital and more time recovering in the comfort of your home. Experience the peace of mind that comes with specialized care and a proven track record of successful outcomes.
Make an Appointment with a Pectus Specialist
The Utah Pectus Program at University of Utah Health makes it easy to get started. You can schedule your initial evaluation directly or work with your primary care provider for a referral.
Schedule and Appointment
Whether you are a new or returning patient, you have several ways to book your appointment:
- By Phone—Call 801-662-2950 to make an appointment.
- Online—Use our online request form to submit your information and have a member of our team contact you.
Referrals and Insurance
While we do not require a formal referral for an evaluation, 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.
If your doctor is referring you to our program, they have several options to send your information:
- Fax referrals—801-662-2980
- Call referrals—801-662-2958
- Online referrals—Complete a professional referral form
Find a Pectus Excavatum Specialist
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