Pectus excavatum (PE) is a structural variation of the chest wall where the sternum and rib cage develop with a distinctly concave, or sunken, appearance. This condition is commonly referred to as “funnel chest” because of the indentation it creates in the center of the chest. While the severity varies greatly, the visual effect often leads to significant self-consciousness and can cause individuals to avoid activities where their torso might be exposed. Fortunately, several non-surgical strategies exist to minimize the appearance of the sunken chest. These concealment methods focus on manipulating external layers, optimizing body mechanics, and using specialized undergarments or padding.
Strategic Clothing Choices
The most immediate method of visual concealment involves carefully selecting external layers and fabrics that prevent the material from sinking into the chest cavity. Avoiding thin, clingy materials, such as lightweight polyester or spandex blends, is a good first step, as these fabrics tend to highlight the body’s contours. Instead, opt for garments made from heavier, more structured materials like thick cotton, denim, or textured knit fabrics, which hold their shape and drape away from the body.
Layering is an exceptionally effective technique for breaking up the chest silhouette and adding volume. A boxier profile helps hide the indentation when wearing:
- A vest
- An open button-down shirt
- A jacket
- A thick sweater over a primary shirt
Busy patterns, such as horizontal stripes or complex geometric prints, can also be useful, as they draw the eye away from the center of the chest and disrupt the perception of depth.
The cut of the garment is also important, with loose-fitting or slightly oversized clothing generally providing better coverage than tight tops. Graphic t-shirts with centralized prints should be avoided, as the print can visibly collapse into the concavity, drawing direct attention to the area. Conversely, a button-down shirt worn unbuttoned over a t-shirt can work well because the two sides of the shirt hang on the pectoral muscles, effectively bridging the dip.
Physical Adjustments for Minimizing Appearance
Beyond clothing, minimizing the appearance of the sunken chest involves addressing posture and building targeted muscle mass. Many people with pectus excavatum develop a compensatory posture, characterized by rounded shoulders and a hunched upper back, which makes the chest indentation appear more pronounced. Correcting this “pectus posture” is a powerful visual adjustment.
Focusing on standing taller and consciously pulling the shoulders down and back helps to project the chest forward, which can significantly lessen the shadowing effect of the concavity. Specific exercises, such as “wall angels” and “chin tucks,” help to strengthen the muscles that support proper spinal and shoulder alignment. Consistent postural awareness throughout the day is necessary to make these mechanical changes permanent.
Targeted muscle building around the chest and upper back can help fill out the area surrounding the sternal depression. Exercises like push-ups, dumbbell chest flys, and cable crossovers strengthen the pectoral muscles, which can create the illusion of a shallower dip. Equally important is strengthening the upper back muscles, such as the trapezius and deltoids, which helps pull the shoulders back and creates a broader, more even upper torso contour.
Supportive Garments and Cosmetic Fillers
Specialized undergarments and external padding systems offer a direct method of concealment by either compressing or filling the chest void. Compression vests or tight athletic-fit undershirts, sometimes called shapers or binders, are worn beneath outer clothing to smooth the chest contour. These garments apply gentle pressure that can hold the outer layer of a shirt taut across the indentation, preventing the fabric from sinking into the depression.
For individuals seeking to fill the space, the use of external “cosmetic fillers” or padding is an option. This non-medical approach involves placing custom-cut foam pieces or soft silicone inserts into the chest depression, often held in place by the supportive compression garment. These inserts are designed to adhere to the skin or fit snugly within the undergarment, providing a smooth, continuous surface underneath the outer shirt.
Minimally invasive filler techniques offer a more permanent solution. Injectable materials, such as fat grafting or specialized hyaluronic acid fillers, can be administered by a medical professional directly into the concavity to augment the tissue and improve the contour. This technique provides an alternative to traditional surgery for cosmetic correction.