Pectus excavatum repair


Pectus excavatum repair, also called "funnel chest repair" or "chest deformity repair," is a type of surgery performed to correct pectus excavatum, a deformity of the front of the chest wall with depression of the breast-bone

In a minimally invasive pectus excavatum repair, two incisions are made on opposite sides of the chest. A clamp is guided beneath the sternum to create a tunnel for the bar (A), which is then fed through (B). The bar is turned over to push the sternum out (C and D) and attached to the ribcage. (Illustration by Argosy.)
In a minimally invasive pectus excavatum repair, two incisions are made on opposite sides of the chest. A clamp is guided beneath the sternum to create a tunnel for the bar (A), which is then fed through (B). The bar is turned over to push the sternum out (C and D) and attached to the ribcage. (
Illustration by Argosy.

(sternum) and rib (costal) cartilages. It is sometimes associaated with Marfan or Poland syndromes.


The chest consists of the rib cage and sternum, which protect the upper-abdominal cavity and its contents. Pectus excavatum, also called "funnel chest" or "depressed sternum" is a deformity that is usually diagnosed shortly after birth. In some people, it is not visible until they are older. The exact cause is not known, but it is believed to be due to overgrowth of the rib cartilage connected to the sternum, which results in the sternum being pushed backward toward the spine. Most people have no symptoms, but if the breastbone is pushed back far enough, heart and lung function may be affected. The purpose of pectus excavatum repair surgery is to correct the deformity to improve physical appearance, posture, and breathing.


In the United States, pectus excavatum is the most common chest wall deformity observed in children, occurring more commonly in boys than in girls. Pectus excavatum tends to run in families. The funnel chest usually progresses as the child grows, often showing a dramatic deterioration during the puberty growth spurt.

Pectus excavatum repair is technically easiest to perform in preadolescent children, and the recovery is faster. However, almost half of the patients undergoing the operation are teenagers. Repair is rarely performed on children under eight years of age. In recent years, a large number of adults over the age of 21 years have undergone repair with equally good results as those observed with children.


Pectus excavatum repair is always performed with the patient under general anesthesia. An epidural catheter is inserted for the management of pain after the operation. The surgeon makes two incisions over the sternum, on either side of the chest, for insertion of a curved steel bar or strut under the sternum. He or she proceeds to remove the deformed cartilages. The rib lining is left in place to allow renewed cartilage growth. The sternum is then repositioned, and the metal strut is placed behind it and brought out through the muscles and skin for future attachment to a brace, which will stay in place six to 12 weeks. The metal strut is fixed to the ribs on either side, and the incisions are closed and dressed. A small steel grooved plate may be used at the end of the bar to help stabilize and fix the bar to the rib. A blood transfusion is not required during surgery. The surgeon may insert a temporary chest tube to re-expand the lung if the lining of the lung is entered.

A variety of surgical procedures are available to repair pectus excavatum.

Nuss procedure

A common technique is the Nuss procedure, developed in 1987 by Dr. Donald Nuss, a pediatric surgeon at Children's Hospital of the The King's Daughters and Eastern Virginia Medical School in Norfolk, Virginia. The procedure is minimally invasive, and results in very little blood loss and short recovery times.

Leonard procedure

Another surgical approach that drastically reduces the time required for surgery is the Leonard procedure, developed by Dr. Alfred Leonard, a Minneapolis thoracic and pediatric surgeon. This operation does not violate the chest, and is combined with a bracing technique.


A pediatrician diagnoses pectus excavatum after observing a child when he or she inhales, exhales, and rests. The pediatrician also calculates the depth of the chest from front to back using x rays of the chest to determine whether the diameter is shorter than average, as is the case with funnel chest. The heart is usually larger and displaced to the left. The pediatrician also evaluates lung capacity using exercise tests and lung scans that can reveal mismatched lungs.

Other diagnostic tests may include:

Before surgery, a bone density test is performed to ensure that the patient does not have soft bones that would deform again right after the surgery. After a complete health history is taken, a patient whose condition is considered severe enough to warrant surgery is sent for a CT scan and further evaluation of his or her pulmonary function.

Because of the great variablity of pectus excavatum among those who have it, custom-made bars (or braces) must be used. The brace is a light vest to which the deformity-correcting wire will be attached at surgery. Patients are fitted with the brace prior to surgery.


Usual recovery time in the hospital is four to five days. Attention is paid to post-operative pain management . The patient is encouraged to breathe deeply, and receives assistance with movement (to avoid dislodging the bar). After discharge, the patient slowly resumes a normal, but restricted, activity level. Most children are able to return to school in two to three weeks, with exercise restrictions for six weeks (no physical education classes, heavy lifting, or athletics).

The pectus excavatum support bar is removed under general anesthesia two to four years after insertion, usually on an outpatient basis. In most cases, patients are able to leave the hospital within one to two hours after bar removal.


Risks associated with pectus excavatum repair include those normally associated with the administration of anesthesia (such as adverse reactions to medications and breathing problems), and risks associated with any surgery (such as bleeding and infection). Specific pectus excavatum surgery risks may include lung collapse (pneumothorax) and the recurrence of the funnel chest. Bar displacement may occasionally require repositioning.

Normal results

Pectus excavatum repair, in almost all instances, restores the ability of patients to participate in full activities, even strenuous activities and athletics. Also, there is a marked improvement in the patient's self image.

Morbidity and mortality rates

According to the National Institutes of Health (NIH), excellent results (95–98%) are reported over a lengthy follow-up time of 25 years. Long-term follow-up (over 15 years) shows that the Nuss procedure provides excellent results with less than 5% recurrence of the deformity after the bar is removed.


Mild cases of pectus excavatum may respond to an exercise and posture physiotherapy program. Many patients with rounded shoulders and a slouching posture have benefited from these techniques, with or without additional surgical correction. However, body-building exercises usually result in worsening of cosmetic appearance due to the enhancement of the pectoral muscles.



Pearson, F. G. Thoracic Surgery. Philadelphia: W. B. Saunders Co., 2002.

Ravitch, M. M. Congenital Deformities of the Chest Wall and Their Operative Correction. Philadelphia: W. B. Saunders Co., 1977.


Engum, S., F. Rescorla, K. West, T. Rouse, L.R. Scherer, and J. Grosfeld. "Is the Grass Greener? Early Results of the Nuss Procedure." Journal of Pediatric Surgery 35 (2000): 246-51.

Genc, A., and O. Mutaf. "Polytetrafluoroethylene Bars in Stabilizing the Reconstructed Sternum for Pectus Excavatum Operations in Children." Chest 110 (July 2002): 54-7.

Hebra, A., B. Swoveland, M. Egbert, E.P. Tagge, K. Georgeson, H.B. Othersen, and D. Nuss. "Outcome Analysis of Minimally Invasive Repair of Pectus Excavatum: Review of 251 Cases." Journal of Pediatric Surgery 35 (2000): 252-7.

Jacobs, J. P., J.A. Quintessenza, V.O. Morell, L.M. Botero, H.M. van Gelder, and C. I. Tchervenkov. "Minimally Invasive Endoscopic Repair of Pectus Excavatum." European Journal of Cardiothoracic Surgery 21 (2002): 869-83.


American Pediatric Surgical Association (APSA). 60 Revere Drive, Suite 500, Northbrook, IL 60062. (847) 480-9576. .

Southern Thoracic Surgical Association. 633 N. Saint Clair St., Suite 2320, Chicago, IL, 60611-3658. (800) 685-7872. .


"Pectus Excavatum Repair." BestHealth. .

Monique Laberge, Ph.D.


Pectus excavatum repair is performed in a hospital by experienced thoracic surgeons who specialize in pectus excavatum repair.


User Contributions:

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Mar 4, 2006 @ 11:23 pm
I have this condition of Pectus excavatum also. But reading the said articles.. it methion of a "cave-in" chest bone.. but my is as "cave-out". Does it have the same effects with those whose are cave-in?
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Apr 26, 2006 @ 2:14 pm
Leonard or Nuss....

what would determine which prodecure a patient should undergo?
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May 5, 2006 @ 6:06 am
Hi i have a sternum that is slightly pushed in. Im 16 and i have recently started bdybuilding. Is their any way, via doing exercises that i can make pushe out over time.

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May 8, 2006 @ 6:18 pm
i have a sternum that is also pushed in about 3/4 inch down. What could I do to make it go away...exercises? surgery? I am 14 years old and I noticed it only about a year ago. Thank you, and please contact me.
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Apr 4, 2007 @ 3:15 pm
hey i was wondering my chest "caves in about half an inch is there a need for surgery or what exercises?
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Aug 7, 2007 @ 7:19 pm
I Have this condition...pectus excavatum, Can i play soccer after the operation?? Please answer
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Aug 19, 2007 @ 1:13 pm
I'm 19 and I also have pectus excavatum, my chect curves in about 2 or 2 and a half inches. I was wondering how severe does this condition have to be to cause potential heart or lung problems?
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Aug 20, 2007 @ 5:05 am
im looking for repair of my PE. please guide me. where are the best opportunities. i am so eager to do so.
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Aug 20, 2007 @ 5:05 am
i am so much interested in nuss procedure. so i like nuss procedure to correct me PE.
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Sep 28, 2007 @ 3:03 am
hi im 18 and having something like a pectus excavatum and was wondering if there was any form of exercise or any other way of curing this other than surgery
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Oct 22, 2007 @ 7:07 am
hi im 16 and i noticed my chest is pushed about 1 inch or a lil bitt more and im into body building. what can i do to let this go away and is body building bad or good for this?
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Oct 30, 2007 @ 6:18 pm
Hi Guys,

I have pectus excavatum as well..I first noticed it in puberty and I am 22 right now. I never worried about it because I always thought I would be able to 'fix' through exercise, since I am in to weightlifting and combat sports. But the truth of the matter is that the disorder only got worse.. I'm now thinking of getting surgery, but I am not sure because there is no physical need for would be just for me to feel better in my own skin..Cheers
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Nov 7, 2007 @ 10:22 pm
Hi - I'm 27 years old. I've got Pectus Excavatum. I've lived with it and never had any problems. I'm a very active individual and after a Chest session (Bench press) in the gym I felt bone moving. Since then my condition has worsend and I feel like I've to gasp for breath, but when I do my morning 5k run - I feel fine. But then it worsens again during the day...Confused...should I get this Surgery done. Who does this in South Africa?
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Nov 14, 2007 @ 8:08 am
i am 17 and have the dipression in my chest but as im female it is not that noticable because of my breasts. but my lower ribs stick out alot and as i am quite slim it is very noticable and makes me feel uncomfortable. the condition does not cause me much trouble but when i am in certain positions and especially when i am walking or carrying something i get very breathless and dizzy and can not fully breath in. i had breathing tests done at birmingham childrens hospital which said it was causing me no lung trouble but these tests were done sitting down only. i also have scoliosis and a rib that is out of place and too close to my heart for doctors to mess with and this is why i have been refused surgery. my doctors have discharged me but i am still not happy. because the condition does not cause any physical problems noticable to them i have been refused of any treatment. major surgery is not an option for me but i have recently found out about other methods of treatment that i was not informed about by my doctors such as the magnetic mini-mover. i would like to know more about these less major treatments and how i would go about getting them. my doctors have not pleased me and i would be very greatful for the help. x
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Nov 25, 2007 @ 3:03 am
Hi, my 17 year old son has severe pectus excavatum and needs surgery. Does anyone know of any doctors in South Africa experienced in the Nuss procedure? I know Dr Nuss is FROM Cape Town but now works in the US. I would appreciate any comments.
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Nov 27, 2007 @ 9:09 am
Hi, My son is 17 years old and has severe pectus excavatum and has been denied surgery due to not having lung or heart problems according to all his tests that he had to perform. What has to take place in order to have this procedure done to correct this matter before it worsens? I just read that a young lady has it but Drs can't perform surgery due to a rib being to close to the heart.
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Dec 16, 2007 @ 10:22 pm
Hi my name is doug and i have pectas excavatum that goes 2 or 3 in. deep i was just wondering if i could play sports after the operation to fix it.
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Jan 3, 2008 @ 1:13 pm
Hello im 22 years old and my chest caves in. I was wondering what kind of exercises do i have to do to make it not show alot. if you have any ideas please send me an email.
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Jan 30, 2008 @ 1:01 am
I'm now 47 and have suffered this since about the age of 14. I lifted weights and did pushups and everything possible to fix it when I was a teenager. Nothing worked and now I just have big, ugly man tits. Just some advice for you young people, nothing I did made it become normal (and I did alot)...and... it is actually only a slight case of PE, about 1/2 to 3/4 inch. But I will say this. It made me who I am today, I wouldn't be the same person if it were normal growing up. While it kept me from doing many things like going to the beach etc. it also gave me alot of inner strength and charachter. That said...if I could have done the surgery that is possible today, I would have done it in a heartbeat!! I'm still considering doing something about it but I'm getting a bit old and not sure if it would be worth it. Good luck to all and don't let it get you down.
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Apr 6, 2008 @ 11:23 pm
Hi, I am 19 and I have a pretty deep funnel. I was wondering if I could do anything?? Is it too late for surgery?? How long am I good for?? If you could just shed some light on this...i would really appericate this! Never been to a doctor and my folks never bothered. Please if u can send me an e-mail.
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Apr 8, 2008 @ 3:03 am
I am 22 and I have done the pectus excavatum surgery by NUSS procedure. I can say that now I am pride of my chest, but only I know how I keep up with the pains in my chest due to the bar on cold or rainy day. Is 1 year since I done the surgery and if u want me to give u an advice: "Forget about your look, accept it, if not u have to know that the post surgery pains are huge!"
Victoria Rivera
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Jun 10, 2008 @ 1:13 pm
My son had surgery in November 2005 for PE correction with the Nuss procedure. His surgery was performed in Guatemala, but now we live in NY, and I am trying to find a doctor who does type of surgery. He is supposed to have the steel bar removed after three years (November 2008). I will appreciate any help on this.
Thank you,
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Sep 18, 2008 @ 1:13 pm
Anyone who is diagnosed with pectus excavatum, should have something done at a younger age if possible. Now, that is of course, my opinion. I'm no doctor, but I'm 30 years old with a wife and daughter. Trust me; you don,t want to have to wait this long. I'm only waiting on the dr. now, pre-ops are done! Hopefully surgery will follow soon. Then I can get some mental clarity.
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Oct 25, 2008 @ 1:01 am
hey, im 14 years old i have pectus excavatum and i noticed the problem when i was about 9 or 10 does anybody have any advice on excercises or surgery for me?
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Nov 2, 2008 @ 5:17 pm
HI!! im a little bit impatient bcause i dont like to take my shirt off bcause i have spectus excavatum. If i do exercise this hole goona desapear or make it worse?? plz i need this, i want to be a wrestler!
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Nov 5, 2008 @ 12:00 am
hey, I am 18 years old and I have just discovered this site. I am not shure if I have a form of Pectus Excavatum, I have about a 1/2 inch depression in my chest, but I also have one side of my rib cage that that sticks out about 3/4's of an inch more than the other side. This basicaly means that my sternom is pushed in, but the one side of my chest sticks out. It is mostly cosmetic, but when i bend over forward I have very restricted breathing and chest pains on my one side that is pushed in, my right side to be exact. I didnt read any of your comments that talk about problems with particular sides of your chest but if there is someone dealing with a similar problem i would be so grateful to here how you are dealing with it or if there are even more people out there with my particulare issue. please talk to me I would realy appriciate a second oppinion.
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Nov 23, 2008 @ 3:03 am
Hi‚ I was wondering how long I should wait after this procedure to start weight lifting?

Many Thanks

Ray Flores
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Dec 30, 2008 @ 7:07 am
I have a 48 year old sister who underwent the Nuss procedure 7 months ago and is still in considerable pain associated with the bar. She is taking strong pain medication every 4 hours. She has consulted with the doctor who performed the procedure and he has said that "all the 40 + year old patients are OK". She has been to the ER several times and has had X-Rays with no obvious problems. Can anyone tell me if this is a normal condition and when the pain should have stopped or at least reduced to a tolerable level? If you have any comments, please send me an email to:
Ray Flores
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Jan 14, 2009 @ 8:08 am
My daughter has been diagnosed with Pectus excavatum after birth, she also has pulmonary stenosis, and vsd. She has been complaining of pain in center of her chest and ped. doc. reccomends surgery. Will her cariologist reccomend this to. She is 11 yrs. old.
thanks for any resources or info u can supply me!!!
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Jan 20, 2009 @ 6:06 am
hi im female, 15 years old and am not sure how bad my sunken chest may be, I have only recently heard of PE and thought that this could be what I have. the bottom of my sternum sinks in and the bottom of my ribs stick out allot. I'm going to go to a doctor soon but would be really grateful to see pictures of other cases, even mild ones so I can compare my condition. Please if anyone could send me some pictures that would be wonderful also label them with details (like how severe the condition, if there has been any treatment or if the doctor has said that it's fine.) THANX a heap.
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Jan 20, 2009 @ 6:06 am
sorry for above wrong email address adress is
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Jan 30, 2009 @ 2:14 pm
hey i would like to know if my PE is bad i have a depresesion of 2.5 cm thanks
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Feb 6, 2009 @ 1:13 pm
I knew my PE was bad when I had shortness of breath, when I had a hard time doing mild exercise because of lack of energy and the inability to catch my breath, and had frequent pain in my chest area. I had surgery (Leonard Procedure) on my PE which ended up being a severe case when I was 17 and I have felt great ever since. I would reccomend sending recent chest x-rays to your PE surgeon of choice to gage the severity, that I what I did.
David Michel
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Feb 23, 2009 @ 2:14 pm
I am an exception to this procedure. I fall into the 5% or less category of having a reoccurence of my sunken chest with it worse than it was to start of with. I had my surgery when i was 15 years of age. My surgeon decided that the best approach for me was the Ravtich approach using the adkin's strut. Basically they made an incision on the side of chest and placed a 5 inch long titanium bar horizontally behind my sternum. i was scheduled to return back to have it removed 6 months later. however just 2.5 months later i was back in surgery because the strut bar had moved to an angle of 45 degrees upward on my left chest. so i was immediately rushed into surgery and had the bar taken out along with half my sternum and a good bit of my 4 lower ribs on my left side. I was told everything was going to be ok. i believed them cuz im not going to lie behind all the scars my chest was pulled out and i was just happy to look normal. well that didnt last too long. i kept growing and growing and my chest started to sink back in and i loss all feeling in that area in my direct center of my chest. not only was the scars horrific but my heart is completely visible. you can see the double beat to my heart perfectly granted it is still covered by a small layer of skin. its dangerous is how i look at it. if someone accidently hot me there i would be totally knocked out. well i am 20 now and i have finally gone back to the same doctors to see what we can to do to fix this new problem. they have me going through a bunch of tests and slightly told me of a different procedure. they want to take whats left of my sternum and rotate it so the front will be in and the back side will be out and then take bone from my knee and fill in the area that is lacking bone. i dont know much more than this considering i just saw them 2 weeks ago but they have a ton of surgeons involved now and honestly i just want all this to be over with. If ANYONE knows any details to this new procedure please email me at please give me any information.
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Feb 23, 2009 @ 11:23 pm
My son is almost 28 and no Doctor ever told us he had pectus excavatum. I was shocked to hear he had it when he was about 20 years old. Later he went into the Army and just came back from Iraq. He wants to have surgery and it is very scary for me. He is beginning to have trouble breathing especially being in the Army.
He needs to find a surgeon that is experienced and preferably in Colorado but willing to go elsewhere for a more experience Doctor in repairing pectus excavatum. Please help us find the right procedure and the best Doctor for this procedure. Thanks so much for your advice. If anyone has any ideas or advice, I would love to hear from you. My email is: Thanks again.
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Mar 4, 2009 @ 4:16 pm
i am 15 years old and i have a funnel chest.. i am worried that as i grow older it will go deeper. is there any excersise i can do such as swimming or is surgery the only way.i have a depresesion of 2cm ..Should everyone with pectus excavatum have surgery?
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Mar 19, 2009 @ 7:07 am
I was diagnosed with PE from the time I was born (1984). At the time my parents were told this is completly cosmetic and everything would be fine. Once I started high school that's when we noticed I wasn't.

Growing up I was always getting respitory infections, I would have broncittis atleast twice a year. In high school I started heavy into sports and even though I was busting my butt I could never keep up and worn down easy. When I was sick breathing would be hard. I actually grew up thinking my chest was supposed to be sunk in I never noticed it until I was changing in the locker room and other noticed. I also used to get severe chest pains.

We finally looked into a solution when I failed my sports physical for cross country. That's when we found i had a severe case, my sternum was centimeters away from my spine and my heart was displaced and one lung slightly collapsed. I had the surgery and it took well over a year to be able to play sports again, but never contact sports. It's now eight years later and my chest is stil stiff. But I can breather easier and I'm not sick nearly as much. I never regained my running endurance back so it all depends what you want to get out of surgery. I still have the bar in they never took it out or told me to take it out. I will say it took a few years but I'm getting chest pains again, not as severe though so I'm dealing with it.

My advice, if it's not physically bothering you don't fix it!! This is no walk in the park surgery. If you can live with the way you look don't fix it. This is a major surgery.

Now I can't tell you what procedure I had, all I know is they compared it to open heart surgery but without touching the heart. I know I have a Titanium bar in me, I think it's the Ravitch Procedure but I have a very long verticle inscion down my chest. They broke my sternum and some ribs to reset it in the correct position. But I was a high schooler and all I cared about was being able to look better, not be sick, and play sports again. So I wasn't always listening.

Hope this gives some insight on my experience.
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Apr 9, 2009 @ 12:12 pm
I have a friend that had this surgery done Jan 2, 2009. It is now April 9, 2009 and he still complains of pain. I know that he goes to the gym regularly. Is this pain normal? It affects his work duties, at rare times he has to lift things that are of light weight, but the majority of his hours are spent in front of a computer. Could he still be in pain or am I to assume that he just doesn't want to work?
8 Year Post-Op pain
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Jul 24, 2009 @ 2:14 pm
My case sounds very similar to a lot of the comments here.
It wasn't until I was around 15 when I started to feel a difference, although I had been able to see one for a while. I had what was commonly known as pigeon chest, where the sternum was actually raised a bit and protruding from my chest. As a member of my high school track team I noticed breathing problems, slight pains, and shortness of breath was above normal. When I went to the doctor, I was told the chest deformity might be the cause of these slight heart palpitations, and that It could cause me problems down the line.
I found a surgeon who acted like this was standard practice and although I was slightly out of her age range 8-16 (I was now 19) It was decided that this would be the best solution. Immediately after coming out of the anesthesia my family and I noticed the extreme beating of my heart right through my skin as if the two were separated only by a thin piece of paper. When asked about this, the doctor said it was completely normal. It wasn't for another couple months, when the pain didn't seem to go away I started asking questions. The doctor became very hard to reach all of the sudden. She was short and distant when I did talk to her, almost realizing the mistake. She advised me that we wouldn't know anything for at least a year, which low and behold to me was when the statue of limitations would run out, releasing her of most liability.
Doctor's aren't always as we might like to believe they are. Like your mechanic, they too make mistakes and may try to cover them up.
I'm not writing this to warn you of crooked doctors although it is to be noted especially by some of the younger crowd on here looking for a cosmetic fix, but instead to share with you what my like is like now.
I have had three repair operations to fix this mistake. A standard "bar" procedure was not used in my case. She left me with whats called a flayed chest. The sternum not connected to the ribs by cartilage leaves two separated pieces which move freely of one another and cause me a significant amount of pain constantly. I have learned to sleep again over the years, and how to sit in cars.
I am by normal standards physically disabled, and still looking for a fix. I have juggled jobs, and school unsuccessfully up until now. I am on high doses of pain medicine and sleep very little. I write to inform the uninformed of what kind of complications and risk are involved in this surgery. My recommendation is to do a lot of research to find the very top doctor money can buy if you decide to undertake this surgery. This isn't a walk in the park. If the surgery is successful I would plan on being in bed for at least a couple months and expect serious pain. Good luck, and remember that if this is strictly cosmetic, it is probably not worth the risk. Besides, our differences are what set us apart and give us character.
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Sep 2, 2009 @ 8:08 am
Our son is 14 and has sever PE. It is affecting his self esteem so badly. we live in Cape Town, South Africa where the medical aid don't pay for the Nuss procedure. Has anybody else been able to motivate for medical aid? The op sounds so scary and as parents we would prefer not to take the risk, but have to consider our son whose daily life is being affected.
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Oct 29, 2009 @ 4:16 pm
My fiance has the opposite of this, his chestbone goes outward and his rib cage sinks in. What is that called??? Please answer ASAP!
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Dec 11, 2009 @ 12:12 pm
I've had this problem since i was a teenager. I'm 34 now. I want to have the Nuss Procedure. Does anyone know of Doctors who do this on adults my age. I live in Washington DC but can travel if needed. Please email me - Thanks!
Alan Andrade
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Dec 15, 2009 @ 6:18 pm
i have Pectus excavatum and it goes in about one inch is that considered minor or severe and it hasn't effected me in any way such as sports and breathing and i don't want to go through all the surgeries ad pain just to make it normal if i doesn't effect my health thanks please reply
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Jan 4, 2010 @ 12:00 am
Hi I didnt really notice I was any different to my friends until my aunty asked my mother why she hadent taken me to the doctor about my chest when i was about 13.. i didnt know any different and I dont think my mother really gave a toss about anything, but to the point.. I am 26 now I have a depression that is about an inch deep, and all through my life I have had heart pains and palpatations, saw left arm, pain up the back of my neck, which is all related to the heart.. sometimes after I go sailboading for a day because i put stress on my chest holding up the sail board.. the next 3 days i can hardly move because my heart is so saw.. i often feel like i can never take deep enough breaths too. I have ben to a few doctors but they all say nothing is wrong with me.. so I think that it must be the sunken chest doing the pain... I live in Australia, Does anyone else have these symptoms with this disease? Im seriously thinking of having it fixed to see if my heart problems go away.
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Feb 19, 2010 @ 10:22 pm
Hello everyone, I am 49 years old and I have been,there done that except having my PE repaired. I just got out of the hospital yesterday 2/18/10 because I was shoveling snow, bending over to pick of the snow on the shovel. It restricted the blood flow in the front of my heart and I begain to have pain in my heart. I waited until the next day and while I was having physical therapy the pain in the middle of my shoulder blades and down my neck to my left arm increased to point that I passed out and had to be taken by ambulance to the hospital. My advice to all is to be very careful when doing anything that requires excessive bending in the forward position for long periods of time. If you are bending forward to do things and you begain to feel pain in the heart, stop and seek medical help to avoid a heart attack. It is a blessing to be able to write to you because I thought it was over for me. Also my two sons 11 and 14 years old are developing PE. At times when I discuss this with the doctor and my son's school district,I feel that they think this is all a pile of Bull S. PE is real and it's effects present life long chellanges.
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Feb 22, 2010 @ 8:20 pm
i was born with pectus but had the nuss procedure done when i was very young, i am 21 weeks pregnant now but my question is will i have any complications with my pregnancy due to my medical history with pectus??
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Mar 14, 2010 @ 10:22 pm
Can anyone tell me please where in NYC this operation is done? or at least a consultation? My sister needs the surgery and I am trying to find out whether there is smth in NY. Thanks
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Mar 16, 2010 @ 11:11 am
This has been by far the most informative page I have found through days of internet searching. My otherwise healthy daughter is being seen by a pediatric surgeon to see what our treatments for this can or will be and being that it is my baby I am researching and looking for answers exhaustively. This answered everything I was wanting to know before going to her surgeon with point specific questions in a few weeks.
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May 12, 2010 @ 12:12 pm
My son just had the Nuss procedure done at Mayo Clinic (May 2010). We are very happy with every aspect, including the initial evaluation, the surgery, the hospital follow-up, and recovery. My son is happier, even while in pain, than he has been for a while.
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May 30, 2010 @ 7:19 pm
I'm glad he's doing fine. What were the pre-op procedures? My son will be getting it done next week.
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Jul 18, 2010 @ 12:12 pm
i will be having the nuss procedure in about 2 weeks and i was wondering what i should expect the day of the surgery please let me know asap thanks :)
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Oct 15, 2010 @ 2:02 am
I am a 28 year old woman, form Cape Town South Africa, who was born with Pectus excavatum. I suffer from heart pulpetations , shortness of breath and regular infetions of the resperatory track. Could someone please answer the following question for me?

1. Is it possible for me to still get corrective surgery at my age
2. Which procedure would be the best option?
3. Is there a surgeon in South Africa that can perform the surgery
4. What would the cost involved be?

Hope to get a reply soon.

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Oct 26, 2010 @ 8:08 am
Mayo Clinic Arizona does the surgery for adult patients. They recently did a 56 male and have done many adult women. Often girls with this condition are ignored because breast development makes it less visible than on males. Patients with symptoms are candidates for repair.
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Feb 11, 2011 @ 10:10 am
Hello all,

I am sorry to hear. God bless all of you, I wish you the BEST!
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Feb 18, 2011 @ 2:14 pm
I am a 40 year old woman, I have had issues with indurance for most of my life, but in the last few years I have developed problems with sleeping, I have pain and pressure in the middle of my chest if I allow my shoulders to roll forward it becomes intolerable quickly also if I start slouching I develop the pressure, if I bend over for very long periods of time I also have pain.
I had a stress test done a few years back that they said didn't show anything. I have become frustated trying to find a doctor that even knows anything about pectus. From previos xrays it looks as if my heart is located pretty much center between my breast bone and spine, I can pretty much fit my fist in the concave area, so I wouldn't call it mild. I had one instance where I was prescribed a anti depressant that made my heart race all day, which in turn caused brusing that made me suffer for 2 weeks. (they told me the lining of my heart was bruised from beating against my sternum all day) This was from 1 pill! Can you help with finding a knowledgeable doctor in Ohio, I know that the Cleveland Clinc has them, but I was hoping for someone maybe closer to Columbus, OH. Thanks
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Mar 22, 2011 @ 2:02 am
My son who is nearly 18, have kept asking me to have surgery or to fix his depressed sternum.I have not been keen to have surgery. His chest depressed about 1 to 2cm. He has done some exercise to try and emprove his chest. On his right he has a very stuck out collar bone. Do you think exercise would work and then not help to have surger?
A bit conerned Mother, not keen for surgery. He dosn't like it and is embarrassed about it.
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Mar 23, 2011 @ 8:20 pm
Hey there, im 15 and i have pectus excavadum. i Know this because i have seen a doctor about it, and i was just wondering if i could play a physical/contact sport like lacrosse or hockey after undergoing the surgery(after waiting the six weeks of course). And also if i will notice the bar in my chest throughout the 4-5 years? thanks
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Mar 28, 2011 @ 3:15 pm
I am 38 a years old and noticed the condition when i was very young. I initially went to a doctor at about age 16 with questions about the condition (which I knew nothing about at the time) but was dismissed as not a big deal and it will go away with butterfly presses. It seems now it has gotten worst and i tend to have back problem due to slouching often i assume and some shortness of breath while im in a sitting position. Generally i dont know where to begin and my experience with a doctors diagnosis was not very successful. Is the NUSS procedure performed on adults?
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Apr 6, 2011 @ 5:05 am
I am 15 and was born with Pectus Excavatum. i was wondering how much it is to get any of the surgery's? i live in Australia. I never had breathing problems before when i had it but now i am starting to get breathing problems with it and sometimes i think it gives me pain in my chest next to the heart. i am also scared to take my shirt off when i am at the beach or pool because of Pectus Excavatum. Any advice really appreciated.
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Apr 11, 2011 @ 8:08 am
Hi Guys

im living testament the Dr Nuss precedure does work , i too used to get funny looks when on the beach people contantly telling me to not bend my back, football coaches telling me im to skinny ,

but this process really does work and is worth the pain i wont lie it did hurt but in the long run is so much better i feel i now have a normal life ( not that it affected my breathing or health)

but it was purely cosmetic , since having it done when i was 18 now 27 i have gained more confidence in myself go gym regularly and have bulk up considerably only showing 4 small scars on my body

looking at these pictures its easy to forget how far we all can come you just have to trust and beleive .. i was monents away from pulling out as they didnt have a bed at great ormond street and got so upset .. but im now so glad i went through with it

so anybody out there doubting if its the right thing to do from my expereince i would say go for it !
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May 2, 2011 @ 9:09 am
Hi im 17 and i was just wondering would the operation for the pectus excavatum ruin the muscle arround the rib cage?
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Jun 24, 2011 @ 11:23 pm
Iam nervous my daughter is 11 yrs n iam scared for her to go under the knife her!doctor said she needs the surgery cause her posture is not good and also that she will have trouble if she decided to have children when she gets older.
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Jul 30, 2011 @ 3:15 pm
i had this procedure done september 2010, it is now july 2011 and the last 10mths have been hell. im 32 and have 3 children, 6, 8 and 10yrs that i can no longer do the things with them that i used to cos the pain from the op is so bad. what i went through straight after the op and for 4 mths after was horrendous and now the pain is still hard to cope with, if i lift shopping bags im in excruciating pain for days and even if i havent it hurts to sneeze, cough and breath also i have been extremly breathless since the op, i have no energy what so ever, it has totally ruined my life. if sites like this didnt pretend how easy the operation is i never would of had it done
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Sep 26, 2011 @ 10:22 pm
My daughter is 8 years old and has PE since birth. For the longest time doctors just said she would have great cleavage but in the past 6 months she went through a growth spurt and it significantly got deeper with her ribs protruding out. Her left rib is sticking out approximatly 3 cm. Her "bowl" as she calls it is already about 2 inches deep. She is a competitive dancer and a snowboarder and I am very nervous because her rib has been hurting her a lot. She has also been diagnosed with Pneumonia 5 times which I think is related to to her PE.I am not sure if I should check about surgery or wait until she is a teenager. She is going for a MRI within the next month and I am hoping that will shine some light on what is going on with her organs.
I would appreciate any comments while she is going through this.
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Oct 16, 2011 @ 9:21 pm
hi im 16 and currently training in a M.M.A class would i beable to fight whilst haveing a inverted chest ?
Steph S
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Nov 4, 2011 @ 11:11 am
I am 24 and have PE. I wish I could get it fixed but i fear that the cave is so deep it is too close to my heart to do anything with. I was literally told that if I were to be punched or hit in the chest hard I could die. It is painful to touch. It is also ugly and had messed my life up so bad it is crazy. I wish my parents would have cared more about me and done somthing about it. I pray my children will not get it. My parents do not, but my fathers brother does. I do not get that. Anyway it is terrible to have. My cave is about 2 1/2 - 3 inches deep and my ribs stick out really bad. This is heartbreaking becasue I am a woman who will never look normal. I feel that I am a freak and should not have children of my own in fear that they will have this as well.
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Nov 13, 2011 @ 4:16 pm
I am 17 years old male and the top of my left side ribcage looks perfectly normal but the top of my right side sticks out a little and 1-2 ribs in the middle-bottom are pushed in, why is that? Could it be that i've fallen and broken my ribs when I was younger and it healed wrong? But the thing is i have no memory of doing so, also can it be fixed somehow? To other it's probably unnoticeable but to me it looks ugly and I have pain there when I run and exercise.
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Nov 26, 2011 @ 3:03 am
Hi, I'm 28 years old, i have a surgey for my PE when I was 17, but it didn't help. So what about Nuss procedure, maybe it could help me? Isn't it too late? maybe i'm too old for that? please answer me on email.
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Dec 9, 2011 @ 7:07 am
My daughter is 22 and had respirtory all her life, the pass several years her respiratory problems has incress tremendously along with her personality and her everyday life. She contacts lung infections at least 2 to 4 times per year or more. I am worried for her health, sleepless nights and stress to the max not sowing on the outside but killing me on the inside. We are now going to be seeing a lung & heart specialist, this procedure will have to take place. It is just a matter of time and the precaution we need to take. Scary for all, very worried Mom.
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Dec 18, 2011 @ 1:01 am
Hey, my name is Daniel, i live in Australia-WA and im 14, i've had Pectus excavatum or "Pigeons Chest" for a while i think, noticed it when i was 12 so probably had it all my life, who knows i can't remember. I'm kind of embarrassed about it, like taking my shirt off at the beach and such, i do take it off and my friends, that haven't seen it before say "WTF is that" or "Hey Daniel whats with your chest", it's quite embarrassing yes. I want to get help/advice on what i should do about it because i do usually have my shirt off with the things i do, beach etc.

It goes in about 1-2 inches and well im not sure if it's effecting me yet, im no doctor. Looking though these comments and page made me think of getting the surgery and it sounds good, i was just wondering about the details and such for the picture at the top of the page, the one where the male i think gets a brace to hold up/support his chest/breast plate on the inside?

My questions are:
1) How much would it cost for this surgery?
2) As i live in Australia-Wa, does anyone know of a doctor that could perform this operation ? Rather it be in one of these places "Perth" "Bunbury" "Busselton"
3) I play Football (AFL) would this effect me in anyway after the operation?
4) Besides the surgery is their anyway i can get this pigeon chest to go away? return to normal?
5)Cost? (asking again because i need to know this one)

Email any answers or questions to me, i'm very keen for this abnormal chest to go away
email address:
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Dec 18, 2011 @ 3:03 am
I'm 16 and i was just wondering if i could start Professionally fighting in Mixed Martial Arts organizations with the same condition described above?. I have been to see two doctors and they just told me that they wont do the operation and not many other doctors will because they don't want to do any operations if they don't have to and they said i was to old for the chest brace. My e-mail is, please e-mail if you know the answer.Thanks.
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Jan 15, 2012 @ 7:19 pm
hi im 13 and i was wondering if i can play soccer after the nuss surgery?
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Jan 22, 2012 @ 2:14 pm
So it's around about $14'000-$20'000 for Nuss surgery, so i've heard/read, thats just a little out of my reach..
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Mar 3, 2012 @ 5:17 pm
I'm 15 and have been trying to train away my pe for about a year and a half. when first started I had a severe condition. Since then my ribs (which were flaring outward) have almost come back into place and the depression is atleast half as sunken or less than it was before. My dad and uncle were both very educated in weightlifting and bodybuilding and were able to show me some great techniques on how to return my chest to normal. I do not feel totally comfortable taking my shirt off but I have posted pictures of myself on social websites and have never gotten a comment on my pe. I think this is because by increasing size and definition I'm my muscles around my pe makes it less noticible. I've never considered surgery because it is not affecting my heart or lungs. I also come from a family of nine and would never ask my parents to pay such a large amount of money just so I could feel good about my chest. But I still don't see the point in surgery if it's not affecting your heart or lungs because even though people won't see the they'll still stare at the long scar across your chest. I also make sure I keep my posture good and stretch my chest often because it also helps to improve my pe. But I have never experienced any pain or worsening of my pe through out my training. I definitely would not recommend to train through pain or keep exercising if it is making if pe worse. I hope I helped some of you and good luck!
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Mar 7, 2012 @ 3:15 pm
I am 61 years ol and was born with PE. I am a femate and was teased my whole life. I dont like my shirts or and material to touch my chest. The material falls into the sunken part of my chest and I was always afraid someone would notice. I am still bothered by the deformity. I will be going this week for a ct scan and hope all is well inside. If they ask me to fix it I would do so in a heart beat. I cannot take a huge deep breath. I always feel kinda short of breath. I cannot get enough of a breath because of my ribs. Also at the very end of my deformed ribs, in the center at the bottom,the bone dipsdown then slightly back up. The end is thick like a step.I have high blood pressue for many years. I think if my chest bone wasnt pushing on on heart i would not have high blood pressure. Just my opion,hope I am correct then I can get ride of all my medicine.I have read all the comments about the pain. Wow,that I do not want.But hope my doctor says to do the operation. Even hearing all the pain comments I will still do it if I get the chance. Just wish me well if it happens.Good luck to all of you. I know what you are all going thru.Good luck to all.
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Jul 13, 2012 @ 8:20 pm
hey i have pectus excavatum in my chest too and i work out alot but i was wondering if a get the surgery to repair my chest would it affect me if i wanna work out after id wait for the surgery to heal and stuff but after that would it be ok to go back to my normal work out please answer back thanks
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Jul 13, 2012 @ 8:20 pm
hey i have pectus excavatum in my chest too and i work out alot but i was wondering if a get the surgery to repair my chest would it affect me if i wanna work out after id wait for the surgery to heal and stuff but after that would it be ok to go back to my normal work out please answer back thanks
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Sep 11, 2012 @ 7:19 pm
My brother was born with a sunken chest and I was not. However, I began to notice that my left ribs were scooped when I was a teenager. It was not very pronounced then so I didn't think much of it. I didn't even know that it was the same thing he had! Over the years, and after 2 pregnancies, it has gotten much worse. Now it sticks out so much that I can not wear certain clothes. My doctors have never said anything about it. I'm sure they've noticed it. Especially having had surgery in my abdomen twice! The next time I see my doctor I will bring it up. IMO, they avoid the subject because, A.) They don't want to be rude by pointing out a flaw that many people would rather live with than fix. B.) It's difficult and painful to fix in many cases. I will have it corrected if I can. I started having breathing trouble around the time I first noticed it... Never connected the two. Also, I have had some dull, annoying pain there many times (especially when I caught a lot). Not to mention the fact I am self conscience of it. If anyone has had it fixed, please let me know if you were happy with the results and which method was used.
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Oct 25, 2012 @ 4:04 am
I am a 23-year-old patient of P.E . Two years ago, I had an operation with a local surgeon hoping to fix my upper and lower dents.
Instead of using less invasive Nuss procedure (my surgeons claims such a strategy is not safe), he applied Ravitch procedure on my chest. My chest was opened up, four pairs of deformed cartilages were removed, the lower part of my sternum was bent outward. However, rather than placing a metal bar under my sternum, he used stitches to fixate it.
Shortly after the operation, a bit of the cartilages grew quickly, while the majority was still stagnant. At this stage, two years have gone, and none of the cartilages (fully) re-grows. Consulting the advice from my own surgeon and other doctors, they quite unanimously state that my cartilages are not likely to grow back, which is fairly devastating to me.
A doctor suggests that by placing two Nuss bars in my chest, and biological patches if necessary, my floating sternum will be stabilized and the cartilages will grow back once my chest wall remains steady. Yet, some other doctors cast doubts on such a way and play down the chance of cartilages regrowth.
Since my surgeon claims that even without the cartilages I can still live my life as usual as normal people, I don’t think he would do anything more to help with my full recovery. Therefore, I would like to consult your advice on my situation, as I am willing to give it a bet for any possible ways of cartilages regrowth.
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Oct 26, 2012 @ 4:16 pm
Hey, I am a 23 year old pe patient. I've been using the vacuum bell for close to a year, but its still not really working. I read on that I should be noticing a difference by now. Does this mean I need to have surgery to get it fixed?
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Nov 2, 2012 @ 5:17 pm
I'm not sure how this forum works but this is a question for Vincent who posted question 79. I was wondering if you had your surgery in the UK. My son had a modified Ravitch operation at Bristol in the UK this year. The chest started sinking back in and the surgeon took him back in for a second operation where he used nylon sutures to hold the sternum up. It appears as if at least one of the ribs has not joined back to the sternum. We have serious doubts about the quality of work by this surgeon and have found another person who has also had problems with him. We have finally been referred to another surgeon at another hospital who is hopefully going to assess my son.

I hope you get your chest sorted out soon and with as little pain as possible.
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Jan 7, 2013 @ 7:19 pm
Hi guy,
Im 15 year old male,
I have went through a pectus excavatum repair during the summer but at this point i was 14 and everything was fine, was put on a morphine drip so i didnt feel any pain. The result is unbelievable and im so happy i went through it. The down side is that about a month after i had the opperation done 2 lump started to develope on my chest, they bleed constantly and puss even comes out, there really really sore, iv been to my GP and they gave me a week of anitbiotics but it didnt help, they had 3 different doctors in looking at my chest because they never came across it before so it had to be something to do with the operation. I went back to hospital to my surgeon and he said it was very rare and that he never came across it before and again he had 3 other surgeons in with him. I was suppose to get them removed today to see whats causing them but the ward i was suppose to be staying in had all of its beds tooken up. The lumps are really painful and i was just wondern is there anyone else that has experienced this after they had a pectus excavatum repair.
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Mar 7, 2013 @ 6:18 pm
can a 69 year old woman have this operation as i am having pain in my back from it? I was told i could have something done about it 50 years ago but did not do anything. at that time i was not suffering from any bad effects. but now my medastinum has moved to the left. my heart is enlarged. would love to know if anybody my age had it done?
thanks sinead
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Jul 6, 2014 @ 6:06 am
I made a surgery for P.E. 10 years ago.I had a severe deformation for my chest. I made it in Romania. I do not know what procedure they used but I have a scar (22 cm long) on my chest. My pectus was fixed 70%. Still is not perfect but is much better than it was before. Curentlly I'm practicing dance and I am plannig to do kickboxing this year. I am curious if I get a punch in my chest could that be dangerous for me?
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Aug 5, 2014 @ 3:03 am
My bar dislodged and punctured my lung 4 months after surgery. 15% of my lung had to be removed. It was still worth the result.
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Oct 16, 2014 @ 10:22 pm
I am a 21 year old female. I had the nuss procedure done about a year ago. I can tell you it is extremely painful but well worth it. I feel much better now but still have painful days. I had been told my whole life it was cosmetic but I persisted and finally got the procedure done. I am in michigan and had a wonderful surgeon. It was a rough process but I feel better and better everyday. I am able to everything I could before and more.
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Nov 12, 2014 @ 11:11 am
My husband who is 27 has P.E. occasionally he experiences chest pain, his doctor said everything looked good in his x-ray. Is this normal to experience or should we see another doctor? Does every P.E. patient need to have it fixed?
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Feb 10, 2015 @ 9:21 pm
Hi guys I have the top part of my ribs sticking out of my chest and one side is bigger than the other I was born with this defect now I'm 16 with a high metobalism and all it does is get bigger and bigger the more my bones grow I don't think it is p.e. but I need answers I'm tired of being judged differently I'm tired of being depressed I really need help with this someone please help
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Apr 2, 2015 @ 8:20 pm
i had pectus and i went through nuss procedure. i had a scale rating of 3.4 with a requirement of 3.25. i have 2 bars placed. it is painful at first for a few weeks but gets easier after. nuss procedure is usually the go to fix as it is minimally invasive. i am happy with the outcome email if have any questions
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Jun 29, 2015 @ 1:13 pm
I am 26 years old and now I noticed that my chest is little bit out ward and today I felt pain in the chest and right behind it..i don't know what is this.. what should I do?
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Sep 11, 2015 @ 7:07 am
Where can I have surgery for Pectus Excavatum in South Africa? Please help.
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Oct 7, 2015 @ 10:10 am
I am now 64 years old and had pectus caved in chest all my life had surgery in 1972 but helped in beginning but now has gone back in and hard for me to breath and get pain every day and high blood pressure so just have to take pain pills and just rest when I am in pain it feels like someone is sitting on top of my chest and have a hard time sitting up
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Dec 6, 2015 @ 3:15 pm
My son had the Nuss Procedure 4 years ago when he was 37 years old. When should the bars be taken out?
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Jan 16, 2016 @ 6:18 pm
I am 14 years old and have i think a mild case of pectus excavatum when i am standing up straight the depression is 1.9cm deep when i tense my abs inwards the depression goes to 1.6cm and when i tense my abs upward it goes to 2.1cm. It makes me very very self-conscious and has ruined many dreams i had about the future i have quite an active lifestyle and want to look as good as possible but my chest gets in the way and makes my body look ugly. i do not think it affects my me physically but i seem to have a lower CRE tolerance than my friends (23 laps in the cooper test) i wanted to do exercise to help the deformity but i've heard it makes it worse. I have an appointment with my doctor in March but i need help now and i doubt i could afford surgery in the UK (Scotland) any help would be appreciated please email me soon.
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Jan 18, 2016 @ 12:12 pm
Quick note for my above post my email is if anyone can help me
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Feb 8, 2016 @ 8:08 am
hi i have a cave-in chest that is very severe i have been told by actual doctors that i have one of the most severe cases of this and i was wondering if you could give me advice on where to go in order to fix the problem that i have thnx
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Mar 1, 2016 @ 12:00 am
My 14 year old son has PE, a specialist advised my GP for me not to do anything unless he starts showing shortness of breath. As he is not able to sit up straight for long periods of time he has developed what looks like stretch marks across the mid-section of his back, is this common? He has also decided he wants to start playing soccer at school, would that cause any problems or are there any dangers to his health due to this and if he is playing soccer is it a good idea for him to wear some sort of chest and back protection gear in case the ball hits him in the chest.
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May 19, 2016 @ 9:21 pm
I have a cave out pectus excavatum, it really makes me feel terrible. Is there an estimate to how much it would cost?
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May 27, 2016 @ 12:12 pm
My son will have a Pectus excavatum procedure done in next 2 weeks (first week on June). Please ask me questions. I will do my best to answer.
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Jun 24, 2016 @ 8:20 pm
Hi I am 15 and i had the PE surgery exactly 4 weeks from now and the physical visual of my chest after the surgery is fantastic but the pain overall was horrible. Each day there is less pain but now I feel like something moves in the sides of my chest where my insicions were made to insert the bar into my chest. It moves everytime I take a deep breath or when I move my arms or raise them. I told my doctor but does not know what is happening, he has done x-rays to see what's wrong but nothing seems to be wrong. Each day I feel something move more and is hurting me on the inside. I need help and if you know what might be the "something" that moves inside of me please help asap thank you.
Aniket kumar
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Feb 17, 2017 @ 2:02 am
my one side rib is depressed inside, i noticed it 3 years ago
i dont have any idea to recover it please give me any suggestion
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Apr 30, 2017 @ 6:06 am
I'm 50 and and have PE and I live in New Zealand. I noticed shortness of breath around 13 years old that caused panic attacks at shcool. I'm otherwise fit healthy and in good shape, albeit slimly built, but often struggle with endurance and confidence. Could anyone advise me on having the Nuss or other procedures done for my age?

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