Pectus Excavatum Symptoms, Causes, and Treatment
Pectus excavatum is a congenital deformity of the chest wall characterized by a sunken or caved-in appearance of the sternum (breastbone) and the adjacent ribs. This condition is sometimes referred to as "funnel chest" due to the distinctive indentation it creates in the chest.
What Is Pectus Excavatum?
A brief definition can be made for the question of what is pectus excavatum. Pectus excavatum, often referred to as "sunken chest" or "funnel chest," is a congenital (present at birth) condition where the breastbone (sternum) is abnormally depressed or indented inward. This creates a noticeable hollow or "funnel" shape in the chest, which can vary in severity. In mild cases, the indentation might be subtle, while in more severe cases, it can be deeper and more noticeable.
While it’s primarily a cosmetic concern, in some cases, pectus excavatum can also cause physical symptoms, such as difficulty breathing, chest pain, or reduced exercise tolerance, particularly during physical activities. The condition might also have a psychological impact due to its appearance.
Pectus excavatum in women is a chest wall deformity where the sternum is sunken inward, which can affect physical appearance and, in severe cases, lead to breathing difficulties or heart issues, though it is often less noticeable in women due to generally lower chest muscle mass.
How Common Is Pectus Excavatum?
How common is pectus excavatum? Pectus excavatum is the most common congenital chest wall deformity. Here's a summary of its prevalence:
- General Prevalence :It's estimated to occur in approximately 1 in 400 individuals. However, ranges have been given from 1 in 300 to 1 in 1000.
- Gender: It's more common in males than females.
- Congenital Condition: It's a congenital condition, meaning it's present at birth, although it may become more noticeable during growth spurts, particularly in adolescence.
- Chest wall deformities: Pectus excavatum constitutes roughly 90% of all chest wall deformities.
Therefore, while it's a relatively common condition, the severity can vary significantly.
Symptoms of Pectus Excavatum
Pectus excavatum can vary greatly in terms of symptoms, and many people with the condition may not experience significant issues. However, in more severe cases, it can lead to both physical and psychological symptoms. Here’s a breakdown of the potential pectus excavatum symptoms:
Physical Symptoms
- Chest Pain: Some individuals may experience discomfort or pain in the chest, especially during physical activity. This can be a result of compression on the heart or lungs.
- Breathing Difficulties: The indentation may compress the lungs or heart, leading to reduced lung capacity, which can cause difficulty breathing, especially during physical exertion or exercise.
- Fatigue: Due to limited lung capacity, some people with pectus excavatum may feel fatigued more easily during physical activities.
- Exercise Intolerance: The condition can reduce the ability to engage in intense physical activity because the chest’s shape may restrict normal respiratory function.
- Heart Palpitations: In severe cases, pectus excavatum can affect the positioning of the heart, potentially leading to irregular heartbeats or palpitations.
- Shortness of Breath: People with more severe cases may experience shortness of breath, especially during exertion, because the chest's shape can limit lung expansion.
Psychological Symptoms
- Body Image Concerns: Due to the noticeable appearance of the chest, individuals, particularly adolescents, may feel self-conscious or embarrassed about their body, which can affect their confidence and self-esteem.
- Social Anxiety or Depression: In some cases, the visible appearance of pectus excavatum may lead to feelings of social isolation, anxiety, or even depression, particularly if the person feels that others are staring or making judgments about their appearance.
Severity Variation
- In mild cases, there might be little to no symptoms. Some individuals with a subtle indentation live their whole lives without experiencing discomfort or functional problems.
- In severe cases, the chest depression can be deep, leading to significant physical issues like lung compression, restricted chest expansion, and possible heart displacement, which may cause more pronounced symptoms.
If someone experiences symptoms that affect their daily life or causes discomfort, they may choose to seek treatment, which could include surgery or physical therapy.
What Causes Pectus Excavatum?
What causes pectus excavatum? The exact cause of pectus excavatum is not fully understood, but it is believed to result from a combination of genetic, developmental, and structural factors. Here are the key factors thought to contribute to the condition:
1. Abnormal Growth of Costal Cartilage
- Pectus excavatum is often associated with overgrowth or abnormal development of the costal cartilage, which connects the ribs to the sternum (breastbone).
This overgrowth pushes the sternum inward, creating the characteristic "caved-in" appearance.
2. Genetic Factors
- There appears to be a genetic component, as pectus excavatum often runs in families.
It is more common in males and may be linked to certain genetic mutations or connective tissue disorders (e.g., Marfan syndrome, Ehlers-Danlos syndrome).
3. Connective Tissue Disorders
- Conditions that affect connective tissue, such as Marfan syndrome or Ehlers-Danlos syndrome, are associated with a higher incidence of pectus excavatum.
These disorders can weaken the structural integrity of the chest wall, contributing to the deformity.
4. Developmental Factors
- Pectus excavatum is a congenital condition, meaning it is present at birth, though it often becomes more noticeable during puberty when rapid growth occurs.
Hormonal changes and growth spurts during adolescence may exacerbate the condition.
5. Other Possible Causes
- Intrauterine Pressure: Some theories suggest that abnormal pressure in the womb during fetal development may contribute to the deformity.
- Vitamin D Deficiency: In rare cases, nutritional deficiencies during early development may play a role, though this is not well-established.
6. Associated Conditions
Pectus excavatum is sometimes seen in conjunction with other conditions, such as:
- Scoliosis (curvature of the spine)
- Mitral Valve Prolapse (a heart valve condition)
- Kyphosis (abnormal rounding of the upper back)
Pectus Excavatum vs. Pectus Carinatum
Pectus excavatum vs pectus carinatum are both chest wall deformities, but they are opposites in terms of how the sternum appears. Pectus excavatum, also known as "sunken chest," involves an inward indentation of the breastbone, creating a concave shape in the chest. In contrast, pectus carinatum, often called "pigeon chest," is characterized by an outward protrusion of the sternum, giving the chest a more prominent or raised appearance. While both conditions are congenital and can affect physical appearance, pectus excavatum may sometimes cause respiratory or cardiac symptoms, whereas pectus carinatum is usually more of a cosmetic concern, though it can also lead to discomfort or difficulty with physical activities in more severe cases. Both conditions can be treated surgically or non-surgically depending on the severity and symptoms.
Is Pectus Excavatum Dangerous?
Is pectus excavatum dangerous? The "danger" of pectus excavatum varies significantly based on its severity. Here's a more detailed look:
Physical Impacts:
- Cardiopulmonary Compromise:In severe cases, the inward-pressed sternum can compress the heart and lungs. This can lead to:Reduced lung capacity, causing shortness of breath, especially during exertion.
- Displacement of the heart, potentially affecting its function and leading to palpitations or irregular heartbeats.
- Decreased exercise tolerance and fatigue.
The degree of compression determines the severity of these effects.
Physical Symptoms:
- Beyond compression, individuals may experience:Chest pain.
- Frequent respiratory infections.
- Postural issues.
Psychological Impacts:
Emotional Distress:
The visible chest deformity can cause significant emotional distress, particularly during adolescence.
This can lead to:Low self-esteem.
- Body image issues.
- Social anxiety.
- Depression.
Impact on Quality of Life:
- These psychological effects can significantly impact an individual's overall quality of life.
When it's considered more dangerous:
Severe Deformity:
- When the indentation is deep and significantly compresses the heart and lungs.
Progressive Symptoms:
- If symptoms worsen over time, especially during growth spurts.
Associated Conditions:
- When pectus excavatum is associated with connective tissue disorders like Marfan syndrome, which can have their own serious complications.
Key Considerations:
- Even mild cases can cause psychological distress.
- Early diagnosis and intervention can help prevent or minimize complications.
- Modern surgical techniques have significantly improved outcomes for severe cases.
In essence, while many individuals with pectus excavatum live normal, healthy lives, it's crucial to consult with a healthcare professional to assess the severity of the condition and determine the appropriate course of action.
Long-Term Complications of Pectus Excavatum
Long-term complications of pectus excavatum primarily stem from the ongoing compression of the heart and lungs, potentially leading to reduced cardiopulmonary function. This can manifest as chronic shortness of breath, decreased exercise tolerance, and persistent chest pain. Furthermore, the psychological impact of the chest deformity can result in long-term emotional distress, including low self-esteem, anxiety, and depression, significantly affecting an individual's overall quality of life. In severe untreated cases, progressive cardiopulmonary compromise can lead to more serious cardiac and respiratory issues later in life.
How Pectus Excavatum Affects Heart and Lung Function
Pectus excavatum can potentially affect heart and lung function, particularly in more severe cases. The inward indentation of the sternum can compress the heart and lungs, which may lead to reduced lung capacity and difficulty breathing, especially during physical activity. The pressure on the heart can alter its normal position and function, sometimes causing symptoms like irregular heartbeats (palpitations).
Reduced lung expansion may also limit oxygen intake, leading to fatigue and shortness of breath. In some individuals, these physical limitations can significantly impact exercise tolerance and overall stamina. However, many people with mild pectus excavatum cases experience no major effects on heart or lung function.
Psychological and Self-Image Concerns
The visible appearance of pectus excavatum can have a significant psychological impact, particularly for adolescents or those with more pronounced deformities. The sunken chest can lead to self-consciousness, embarrassment, or feelings of inadequacy, often affecting self-esteem. Individuals may become anxious about social interactions, fearing judgment or teasing. In some cases, this can lead to increased social isolation, body image issues, or even depression.
The psychological burden of the condition, particularly during the formative years, can be just as challenging as the physical aspects, leading some to pursue treatment options for both cosmetic and emotional well-being.
Diagnosis of Pectus Excavatum
Pectus excavatum is typically diagnosed through a combination of physical examination and imaging tests. During the physical exam, a doctor will visually assess the chest for the characteristic sunken appearance and may also feel the chest wall to measure the depth of the indentation. In some cases, the condition is first noticed during a routine check-up or as part of an evaluation for other health concerns.
Tests Used for Pectus Excavatum Diagnosis
X-ray: An X-ray of the chest is often the first imaging test used to assess the severity of the condition. It helps visualize the degree of the chest indentation and any potential impact on the heart and lungs.
CT Scan (Computed Tomography): A CT scan provides a more detailed view of the chest, allowing for precise measurements of the indentation. It can also show how the condition might be affecting the heart, lungs, and surrounding structures.
MRI (Magnetic Resonance Imaging): An MRI is sometimes used to evaluate the heart and lungs' function more closely. It offers detailed images of soft tissues, which can be helpful in understanding any impacts on cardiac or pulmonary function.
Echocardiogram: An echocardiogram uses ultrasound waves to produce images of the heart. It may be used to assess whether the condition is affecting heart function, such as causing displacement or compression of the heart.
Pulmonary Function Tests: These tests are used to measure lung capacity and the efficiency of breathing. They can help determine if pectus excavatum is affecting the individual's lung function, especially in cases where there are symptoms like shortness of breath or fatigue.
Barlow's Test: This is a physical exam technique used to estimate the severity of the chest depression by measuring the depth of the indentation.
Pectus Excavatum Treatment Options
Pectus excavatum treatments options vary depending on the severity of the condition and the patient's symptoms. Here's an overview:
1. Non-Surgical Treatments:
Vacuum Bell Therapy:
- This involves using a concave device that creates a vacuum to lift the sunken sternum.
- It's often used for younger patients with more flexible chest walls.
- It requires consistent daily use over a prolonged period.
Physical Therapy:
- Exercises can help improve posture and strengthen chest muscles, which may alleviate some symptoms.
- It's often used in conjunction with other treatments.
2. Surgical Treatments:
Nuss Procedure (Minimally Invasive Repair):
- This is the most common surgical approach.
- It involves inserting curved metal bars through small incisions to lift the sternum.
- The bars remain in place for several years and are then removed.
Ravitch Procedure (Open Repair):
- This is a more traditional open surgery.
- It involves making a larger incision to remove or reshape the cartilage causing the deformity.
- It may be used in more complex cases.
Key Considerations:
- Severity of the Condition: Mild cases may not require any treatment, while severe cases may necessitate surgery.
- Patient's Age: Younger patients may benefit more from non-surgical options due to greater chest wall flexibility.
- Symptoms: Treatment is typically recommended for individuals experiencing significant physical or psychological symptoms.
- Psychological Impact: In some cases, treatment may be pursued primarily to address psychological concerns related to the chest deformity.
It's important to consult with a healthcare professional, particularly a thoracic surgery, to determine the most appropriate treatment plan.
Can Pectus Excavatum Be Treated Without Surgery?
Yes, pectus excavatum can be treated without surgery in some cases, particularly when the condition is mild or does not cause significant physical or emotional symptoms. While surgery is often the most effective option for severe cases, non-surgical treatments may help improve the condition or manage symptoms, especially for individuals with less pronounced deformities.
Non-Surgical Treatment Options:
1. Physical Therapy and Exercise:
- Postural exercises can help improve the posture and chest expansion, which may reduce the appearance of the sunken chest and improve breathing function. Exercises that focus on strengthening the muscles around the chest and improving lung capacity may also help with any respiratory limitations.
- Breathing exercises: Techniques such as diaphragmatic breathing may be used to increase lung capacity and improve overall respiratory function.
- Bracing: In some cases, a custom-fitted chest brace may be recommended, particularly in younger individuals whose bones are still growing. The brace is worn for several hours a day and helps to apply gentle pressure to gradually push the sternum outward. This method is often used in adolescents to correct the deformity before their bones harden completely. However, the effectiveness of bracing is debated, and it’s usually only recommended for mild to moderate cases.
- Vacuum Bell Therapy: Vacuum bell therapy is a non-invasive treatment that uses a suction device to gradually lift the depressed sternum. It is most effective in individuals with mild to moderate pectus excavatum. The device creates a vacuum between the chest and the bell-shaped cup, which can help pull the breastbone outward over time. Regular use is required, and results may vary from person to person.
2. When Surgery Is Not Needed:
- Mild cases of pectus excavatum that don’t cause any symptoms or significant functional issues may not require surgery. In these cases, non-surgical treatments like exercise and physical therapy might be sufficient to manage the condition or improve chest appearance and breathing capacity.
- Psychological impact: For individuals primarily concerned about the cosmetic appearance, non-surgical options may be helpful, but they might not provide the same dramatic results as surgical correction.
However, for moderate to severe cases that cause significant symptoms (e.g., chest pain, difficulty breathing, or reduced exercise capacity), surgery is usually recommended to correct the deformity and relieve physical symptoms.
Pectus Excavatum Exercises and Physical Therapy
While pectus excavatum exercises and physical therapy won't correct severe pectus excavatum on their own, they can play a valuable role in managing symptoms, improving posture, and strengthening supporting muscles. Here's a breakdown:
Goals of Exercise and Physical Therapy:
- Improve Posture: Many individuals with pectus excavatum develop poor posture, which can exacerbate symptoms. Exercises can help correct these postural imbalances.
- Strengthen Chest Muscles: Strengthening the muscles surrounding the chest wall can provide better support and improve breathing mechanics.
- Increase Lung Capacity: Certain breathing exercises can help expand lung capacity and improve respiratory function.
- Reduce Pain: Exercises can help alleviate chest pain and discomfort associated with the condition.
- Improve Flexibility: Stretching exercises can improve flexibility in the chest and upper back.
Types of Exercises:
- Posture Correction Exercises: These focus on aligning the spine and shoulders. Examples include wall angels, shoulder blade squeezes, and chin tucks.
- Chest Muscle Strengthening Exercises: These target the pectoral muscles and surrounding muscles.
Examples include:
- Light resistance band exercises.
- Gentle chest presses (with light weights or resistance).
- Isometric chest exercises.
Breathing Exercises: These focus on deep breathing and expanding the ribcage. Examples include:
- Diaphragmatic breathing.
- Pursed-lip breathing.
- Incentive spirometry.
Stretching Exercises: These improve flexibility in the chest, shoulders, and upper back. Examples include:
- Chest stretches (using a doorway or wall).
- Upper back stretches.
Physical Therapy's Role:
A physical therapist can:
- Develop a personalized exercise program tailored to the individual's needs.
- Teach proper exercise techniques.
- Monitor progress and make adjustments as needed.
- Provide manual therapy to improve mobility.
- Physical therapy is often used in conjunction with other treatments, such as vacuum bell therapy or after surgery.
Important Considerations:
- It's crucial to consult with a doctor or physical therapist before starting any exercise program.
- Exercises should be performed gently and gradually, avoiding any movements that cause pain.
- Consistency is key. Regular exercise is essential for achieving and maintaining improvements.
- Exercises will not fix the structural defect, but rather improve the quality of life of the person with the defect.
Pectus Excavatum Surgery
Pectus excavatum surgery aims to correct the inward depression of the sternum, improving both physical function and cosmetic appearance. The two main surgical approaches are the minimally invasive Nuss procedure, where curved metal bars are inserted to lift the sternum, and the more traditional open Ravitch procedure, which involves reshaping the cartilage and sternum. The choice of procedure depends on the severity of the deformity, the patient's age, and other individual factors. Surgery is typically recommended for individuals experiencing significant cardiopulmonary symptoms or psychological distress due to the condition.
The Nuss Procedure: Minimally Invasive Repair
The Nuss procedure is a minimally invasive surgery commonly used to treat pectus excavatum. It involves the insertion of a curved metal bar under the chest to push the sunken sternum outward. The procedure is typically done through small incisions on the sides of the chest, making it less invasive than traditional surgeries. The bar is placed temporarily (usually 2-3 years) to reshape the chest, and it is later removed once the chest wall has been sufficiently corrected. The Nuss procedure is favored for its quicker recovery time and smaller incisions, leading to less scarring compared to traditional methods.
The Ravitch Procedure: Traditional Surgical Approach
The Ravitch procedure is a more traditional, open surgical approach for treating pectus excavatum. It involves a larger incision across the chest, through which the surgeon removes the cartilage that is causing the depression of the sternum. The sternum is then repositioned and supported with a metal bar or other reinforcement. The Ravitch procedure is typically recommended for more severe cases or when the Nuss procedure is not appropriate. Although it requires a longer recovery time and leaves more noticeable scars, it can be very effective for reshaping the chest wall in complex cases.
Pectus Excavatum Surgery for Adults vs. Children
Pectus excavatum surgery can be performed on both adults and children, but there are differences in the approach and outcomes.
In Children and Adolescents: Surgery is often more effective when done in younger patients whose chest walls are still growing and flexible. The Nuss procedure is commonly used for children, as their bones are more malleable and recovery tends to be faster. The surgery is typically performed before puberty, but can be done into the teenage years.
In Adults: Surgery can still be successful for adults, but recovery tends to be more challenging as the bones are less flexible. Adults may need a longer period to heal, and complications like chronic pain or difficulty breathing may occur more frequently. Pectus excavatum surgery for adults, the Ravitch procedure may be preferred, especially in cases with severe deformities, as it allows for more extensive correction.
Recovery After Pectus Excavatum Surgery
Recovery after pectus excavatum surgery typically involves a hospital stay of 3-7 days, depending on the procedure performed. Pectus excavatum surgery recovery time generally ranges from 3 to 6 months, with most patients returning to light activities within a few weeks and resuming full physical activities after about 6 months. Post-surgery, the recovery process includes:
Pain Management: Pain is usually managed with medications, and patients may experience soreness and discomfort in the chest, especially for the first few weeks.
Physical Activity: Patients are generally advised to avoid heavy lifting and strenuous activities for several months. Light activities can be resumed after a few weeks, but full recovery may take 6 months or longer.
Follow-up Appointments: Regular follow-ups are essential to ensure proper healing and to monitor for any complications, such as infections or issues with the bar placement (in the case of the Nuss procedure).
Postoperative Care: Patients may need to wear a chest binder or brace for several weeks to help support the chest as it heals. If a metal bar is used (Nuss or Ravitch procedure), it will remain in place for up to 2-3 years before being removed in a follow-up surgery.
Risks and Complications of Pectus Excavatum Surgery
While pectus excavatum surgery is generally safe, like any surgery, it carries risks, including:
Infection: As with any surgical procedure, there is a risk of infection at the incision sites or around the metal bar.
Pneumothorax (Collapsed Lung): This is a potential complication during surgery, particularly with the Nuss procedure. The lung can be accidentally punctured during the insertion of the bar.
Bar Displacement or Fracture: In the case of the Nuss procedure, the metal bar can shift or break, requiring additional surgery to correct.
Chronic Pain or Discomfort: Some patients may experience long-term pain or discomfort, particularly around the area where the bar is placed or after it is removed.
Scarring: The Ravitch procedure leaves a larger scar due to the open chest incision, though it generally fades over time.
Anesthesia Risks: As with any surgery, there are risks associated with anesthesia, including allergic reactions or complications for individuals with preexisting health conditions.
Pectus Excavatum Surgery Cost
Pectus excavatum surgery cost can vary widely based on factors such as location, the surgeon's experience, the complexity of the case, and whether the procedure is done in a hospital or outpatient center.
Without insurance, the cost for the Nuss procedure can range changeable, while the Ravitch procedure may be similarly priced or slightly higher due to the more invasive nature of the surgery.
With insurance, costs may be significantly reduced, as many insurance plans cover pectus excavatum surgery when it is deemed medically necessary (such as for breathing difficulties, chest pain, or other health concerns). However, out-of-pocket costs can still include copayments, deductibles, and other related fees.
Why Choose Liv Hospital for Pectus Excavatum Treatment?
Liv Hospital is renowned for its expertise in treating complex conditions like pectus excavatum. With a focus on advanced treatment methods and compassionate care, Liv Hospital provides comprehensive solutions for patients seeking both functional and cosmetic improvements. Whether you're considering non-surgical options like vacuum bell therapy or need surgical intervention such as the Nuss or Ravitch procedure, Liv Hospital offers a range of effective treatments tailored to individual needs. The hospital's commitment to patient-centered care, expert surgeons, and state-of-the-art technology makes it an excellent choice for those seeking high-quality pectus excavatum treatment.
Cutting-Edge Medical Technology at Liv Hospital
Liv Hospital prides itself on using the latest medical technologies to diagnose, treat, and monitor pectus excavatum. The hospital is equipped with advanced diagnostic tools such as high-resolution CT scans, MRI, and echocardiograms, which allow for precise evaluation of the chest wall deformity and any impact on heart and lung function. Additionally, Liv Hospital offers minimally invasive techniques like the Nuss procedure, utilizing specialized tools to minimize incisions and speed up recovery. With a focus on precision, patient safety, and optimal outcomes, Liv Hospital leverages the best technology available to provide the highest level of care for those with pectus excavatum.
International Patient Services at Liv Hospital
Liv Hospital welcomes international patients, offering a seamless healthcare experience for those traveling from abroad for pectus excavatum treatment. The hospital provides a dedicated International Patient Services team to assist with every aspect of the process, from initial consultation and medical evaluations to travel arrangements and post-surgery care. The team ensures that international patients receive personalized support throughout their treatment journey, making their visit as comfortable and stress-free as possible. With services available in multiple languages and a focus on catering to diverse cultural needs, Liv Hospital is an excellent choice for individuals seeking high-quality medical care from across the globe.
FAQ About Pectus Excavatum
Does pectus excavatum get worse with age?
To the question does pectus excavatum get worse with age, we can briefly say yes. Pectus excavatum baby is a congenital condition where the breastbone grows inward, causing a noticeable sunken appearance in the chest, which is usually asymptomatic but may require monitoring for potential complications.Pectus excavatum may worsen with age, particularly if left untreated during childhood or adolescence.
The condition can become more noticeable during periods of growth, especially during puberty when the chest wall is still developing. As the individual grows older, the sternum may become more rigid, making the pectus excavatum deformity more pronounced. In some cases, if pectus excavatum is not addressed, it could potentially cause more physical discomfort, including breathing or heart problems, due to increased compression on the chest organs.
Can pectus excavatum cause breathing or heart problems?
Yes, in more severe cases, pectus excavatum can cause both breathing and heart problems. The indentation of the sternum may restrict lung expansion, leading to reduced lung capacity, shortness of breath, and difficulty breathing, especially during physical exertion. The condition can also cause the heart to be displaced or compressed, potentially leading to arrhythmias or heart palpitations. However, these issues are generally more common in moderate to severe cases.
Is surgery the only option for treating pectus excavatum?
No, surgery is not the only option for treating pectus excavatum. Non-surgical treatments are available, particularly for mild to moderate cases. These may include:
Physical pectus excavatum therapies and postural exercises to strengthen chest muscles and improve posture.
Vacuum bell therapy, which uses a suction device to gradually lift the sunken sternum.
Bracing for younger patients with still-growing bones, which can help reshape the chest wall over time.
Surgery is typically considered for more severe cases or if the condition pectus excavatum causes significant breathing or cardiovascular problems.
How effective is the vacuum bell for pectus excavatum?
The pectus excavatum vacuum bell can be effective, particularly for mild to moderate pectus excavatum, and when used consistently over time. It works by creating a gentle suction that gradually lifts the sunken sternum. The device is most effective when used in younger individuals with flexible chest walls, as their bones are more responsive to reshaping. However, results may vary, and it may not be as effective in more severe cases or for older patients whose chest bones have become more rigid.
Does pectus excavatum surgery leave visible scars?
Yes, pectus excavatum surgery typically leaves visible scars, though the extent and visibility depend on the type of procedure. The Nuss procedure, which is minimally invasive, leaves small incisions on the sides of the chest. These scars are generally less noticeable than those from the Ravitch procedure, which involves a larger incision across the chest to remove cartilage and reposition the sternum. Scarring from surgery usually fades over time but can be more prominent initially.
What are the risks of not treating pectus excavatum?
If pectus excavatum is left untreated, particularly in severe cases, it can lead to long-term complications such as:
- Respiratory issues, including reduced lung capacity, difficulty breathing, and exercise intolerance.
- Cardiac issues, including compression of the heart, leading to arrhythmias or palpitations.
- Psychological effects, such as low self-esteem, social anxiety, or depression, due to the cosmetic appearance of the chest.
- Chronic pain in the chest, particularly during physical activity.
Treatment can help alleviate or prevent these complications, especially if the condition is diagnosed early.
Can adults get pectus excavatum surgery?
Yes, adults can undergo pectus excavatum surgery, although the procedure may be more challenging than in younger patients. Adults have more rigid chest walls, which can make the bones less responsive to reshaping. While surgery is still effective for adults, recovery may take longer, and there may be a higher risk of complications such as chronic pain. The Nuss and Ravitch procedures can both be performed on adults, with the choice of procedure depending on the severity of the condition and the patient's individual needs.
How painful is pectus excavatum surgery?
Pectus excavatum surgery can be painful, particularly during the first few days after the procedure. Pain is typically managed with prescription pain medications and nerve blocks that help reduce discomfort. After the surgery, you can expect soreness around the chest, especially at the incision sites and around the area where the metal bar or supports are placed. While recovery varies from person to person, most individuals report that the pain subsides within a few weeks, though some discomfort may persist for several months, especially when engaging in physical activity.
Will I need physical therapy after surgery?
Yes, many patients need physical therapy after pectus excavatum surgery, especially if the pectus excavatum nuss procedure was performed. Pectus excavatum physical therapy can help improve range of motion, strengthen chest muscles, and restore full functionality to the chest wall. It also helps in reducing stiffness and promoting proper posture during the recovery process. Physical therapy is typically started a few weeks after surgery, once the initial healing has taken place.
How soon can I return to normal activities after surgery?
Returning to normal activities after pectus excavatum surgery varies depending on the type of surgery and the individual’s recovery. Generally:
- For the Nuss procedure, patients can resume light activities within 4-6 weeks but should avoid strenuous exercises for 3-6 months to allow the chest to fully heal.
- For the Ravitch procedure, recovery is typically longer due to the more invasive nature of the surgery. 6-8 weeks of recovery is common before light activities can be resumed, and 3-6 months before returning to more vigorous activities.
* Contents of this page is for informational purposes only. Please consult your doctor for diagnosis and treatment. The content of this page does not include information on medicinal health care at Liv Hospital .
