Do I Need Treatment for Pectus Carinatum? Risks and Options Explained

Does chickenpox require treatment?

I have pectus carinatum.
Although it doesn't affect my daily life, it makes me feel very self-conscious.
Can it be treated? Is the surgical risk high? How much does it cost? What are the treatment options? How long is the recovery? Thank you for your response, doctor!

Ni Qi, 20~29 year old female. Ask Date: 2005/04/19

Dr. Chen Xingyuan reply Orthopedics

Dear Ms.
Nikki,
The treatment for pectus carinatum (commonly referred to as "chicken breast") falls under the scope of thoracic surgery, and it would be best to consult a specialist in this field for satisfactory answers.
Attached is some online information for your reference (Taipei Medical University).
Wishing you health and safety!
Sincerely,
Dr.
Chen
---
Uneven chest: Is it pectus carinatum or pectus excavatum? Abnormal development of the sternum is mostly due to congenital rib development anomalies.
The chest wall is surrounded by ribs on both sides, and when the ribs grow excessively long, they can compress the costal cartilage at the junction with the sternum, causing the sternum to either protrude or sink.
Protrusion is known as pectus carinatum, while sinking is referred to as pectus excavatum or funnel chest.

Pectus excavatum is the most common congenital chest wall deformity.
Externally, it can be as small as a tennis ball fitting without falling or as large as a significant depression between the breasts, severely affecting cardiopulmonary function.
Due to the rib deformity, the sternum can sink towards the spine, and in the most severe cases, the sternum can be very close to the vertebrae, pushing the heart, which is normally situated between the two, towards the left.
This reduces the expansion space for the lungs and can impact heart and lung function.
The position and shape of the compressed heart and lungs can be clearly diagnosed through computed tomography (CT) scans.
The treatment for pectus excavatum is surgical correction, indicated in cases of severe cosmetic deformity, such as deep funnel-shaped depressions, and abnormalities in cardiopulmonary function.
The optimal age for surgery is typically between 3 to 6 years old.
Currently, innovative surgical techniques allow for smaller incisions and better alignment with aesthetic needs.
Post-surgery, in addition to standard care, there is a 2-3% chance of recurrence, so it is crucial to engage in related rehabilitation activities.
If attention is paid to nutrition and localized chest exercises postoperatively, the likelihood of recurrence can be significantly reduced.

Reply Date: 2005/04/19

More Info

Pectus carinatum, commonly referred to as "pigeon chest," is a condition characterized by an abnormal protrusion of the sternum and rib cage. While it may not significantly impact daily activities or overall health, many individuals with this condition experience psychological distress due to its appearance. Understanding the treatment options, associated risks, and recovery process can help you make an informed decision.

Treatment Options
1. Observation: If pectus carinatum is mild and does not cause any physical discomfort or functional impairment, your doctor may recommend a watchful waiting approach. Regular follow-ups can help monitor any changes in the condition.

2. Bracing: For individuals who are still growing, especially children and adolescents, a custom-fitted brace can be an effective non-surgical treatment. The brace applies pressure to the chest wall, gradually reshaping the sternum over time. This method is generally well-tolerated and can be effective if worn consistently, often for several months to a few years.

3. Surgery: Surgical intervention is typically considered for moderate to severe cases of pectus carinatum, especially if the condition causes significant psychological distress or physical discomfort. The most common surgical procedure is the Ravitch procedure, which involves removing the abnormal cartilage and repositioning the sternum. Another option is the minimally invasive Nuss procedure, which places a curved metal bar under the sternum to reshape the chest wall.

Risks of Surgery
As with any surgical procedure, there are risks involved, including:
- Infection: There is a risk of infection at the surgical site.

- Scarring: Surgery can leave visible scars, which may be a concern for some patients.

- Anesthesia Risks: General anesthesia carries its own set of risks, particularly for individuals with underlying health conditions.

- Recurrence: In some cases, the chest may revert to its original shape after surgery, necessitating further treatment.

Costs
The cost of treatment can vary widely based on the type of intervention chosen, the surgeon's fees, hospital charges, and geographic location. Non-surgical options like bracing are generally less expensive than surgical procedures. Surgical costs can range from several thousand to tens of thousands of dollars, depending on the complexity of the surgery and any additional care required.

Recovery Time
Recovery from surgery typically involves a hospital stay of a few days, followed by several weeks of limited activity. Most patients can return to normal activities within 4 to 6 weeks, but full recovery may take several months. Physical therapy may be recommended to aid in recovery and improve chest wall function.

Conclusion
While pectus carinatum may not pose significant health risks, the psychological impact can be considerable. If you are experiencing self-esteem issues due to the condition, it is worth discussing treatment options with a healthcare provider. They can help you weigh the benefits and risks of each approach, including bracing and surgical options. Ultimately, the decision should align with your personal preferences, lifestyle, and the severity of your condition. Consulting with a specialist in thoracic surgery or a plastic surgeon experienced in chest wall deformities can provide further insights tailored to your specific situation.

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