Pectus carinatum is a chest wall deformity where the breastbone and ribs protrude outward. Also known as “pigeon chest,” this condition can be a source of concern.
Understanding Pectus Carinatum
This protrusion results from abnormal growth of the cartilage connecting the ribs to the breastbone. While it can be present from birth, the condition becomes more noticeable during rapid growth phases, particularly in adolescence.
The appearance can vary, sometimes affecting one side more than the other, creating an asymmetrical chest. Although primarily a cosmetic concern, some individuals may experience mild physical symptoms, including chest pain during physical activity or, less commonly, shortness of breath with exertion.
Does Pectus Carinatum Resolve Naturally?
Pectus carinatum does not resolve on its own. The structural nature of this deformity, involving cartilage and bone, means it does not correct itself with time. The protrusion becomes more prominent during periods of rapid growth, such as puberty. Beyond the physical manifestation, the visible nature of pectus carinatum can lead to psychological impacts, affecting self-confidence and body image, particularly in teenagers.
Non-Surgical Treatment Options
Non-surgical approaches are the first line of treatment for pectus carinatum, especially in growing individuals. The primary non-surgical method involves a compression brace. This custom-made device applies consistent, external pressure to the protruding breastbone and ribs.
The brace works similarly to orthodontic braces, gradually reshaping the chest wall over time. This treatment is most effective for adolescents whose chest walls are still flexible. Consistent wear for 8 to 12 hours a day is important for successful outcomes, with treatment durations ranging from six months to two years.
Surgical Treatment Options
When non-surgical methods are not suitable or effective, surgical interventions can be considered for pectus carinatum. One established surgical technique is the modified Ravitch procedure. This open repair involves making an incision to remove the abnormally grown cartilage and then reshaping and repositioning the sternum.
Another approach is the Abramson procedure, a minimally invasive technique. This procedure involves placing a metal bar underneath the skin and muscle, over the most prominent part of the sternum, to press it inward. Surgery is reserved for cases where bracing has been ineffective, for older patients, or when there are significant cosmetic or physical concerns.