I have pectus excavatum, and I'm writing this article to help people understand what this condition is, what it involves, and the impact this condition has had on my daily life.
Pectus excavatum is the medical term for a chest deformity. It is sometimes also referred to as pigeon or funnel chest. The chest deformity is distinguished by a sunken sternum accompanied usually with flared ribs. Pectus excavatum will also cause some of the internal organs to be displaced; for example, the heart could be pushed up, down, or more to the left than normal. It is only when the heart is being obstructed or pushed against that the condition requires surgical correction.
There is also an opposite type of chest deformity called pectus carinatum, which is distinguished by a pushed-out sternum and chest.
Causes of Pectus Excavatum
There is much speculation into what the real cause of pectus excavatum is; however, the real reason is still unknown. Some believe it to be poorly coordinated bone structure, and others believe it is related to an overgrowth of bones in birth. Another hypothesis involves a lack of zinc and magnesium in the bones, which could possibly cause them to bend unnaturally.
For me it was simply that both my father and his father also had mild pectus excavatum, and they passed it down to me. I was the only one who inherited it, as it seemed to skip my brother entirely. Genetics is the most common cause of this condition, and if you find you have a slightly sunken sternum, it is likely that someone in your family has the same condition.
Growing Up With a Chest Deformity
The most common effects people with P.E will experience when growing up is low self esteem and a lack of confidence. This is due to being embarrassed to take off your shirt in public, as people will often stare at you and think you're some sort of freak.
As a young kid I experienced this embarrassment. The condition made me appear even skinnier than I actually was. I looked quite malnourished, when in fact I ate like a horse and played basketball 3 times a week.
Looking back on it now, it wasn't actually as bad as I felt it was at the time. You just have to try to not let all the stares bother you and be confident. Who cares if your chest doesn't look like every other sheep. It is unique, and if it's not giving you any real trouble it's something you can definitely live with and be happy.
Severity of the Condition
There are three main levels of pectus excavatum. They are mild, moderate, and severe.
Mild - The sternum is sunken only a little bit and sometimes it is barely noticeable the really mild pectus excavatum usually does not involve flared ribs unless the persons posture is poor.
Moderate - The sunken sternum is obvious when shirtless and often accompanied by flared ribs. The mild and moderate P.E often don't cause any trouble for the person unless bordering on severe.
Severe - This level of pectus excavatum usually requires surgery as the sunken sternum can be quite deep and can be putting a lot of pressure on the heart causing poor blood circulation , pain and difficulty breathing.
Even Billy Zane Has P.E.
Correcting your Pectus Excavatum
Many people opt to have the surgery to repair there P.E condition. The most commonly performed surgery is the NUSS procedure where a bar is inserted in the chest cavity and the bar is made in such a way that it will exert pressure outwardly onto the sternum to push the sternum out to the neutral position. This can be a very painful surgery and can take around 3 years to fully recover so its best to have it at a younger age.
The surgery has been performed for around 15 years now I believe and has been very successful but surgery isn't always the option many people use exercise and other cosmetic methods to improve the appearance of there chest.
Many people head to gym to improve there pectus excavatum appearance but there is a big misconception that using weight exercises will help fill in the sunken sternum as this is technically impossible as there is no muscle around your sternum unless you plan on building a greek god like chest.
The main thing people can work in the gym is a way to improve there postures and strengthen there back muscles ( back muscles will be stretched because of the sunken sternum often causing stretch marks on the back). Correcting your posture at the gym or out of the gym will go along way to improving your appearance because as posture improves your ribs and sternum will slowly begin returning to a normal position.
Be sure to check out my other articles on Pectus Excavatum Repair. It has a list of exercises with specific details and images to help you improve your chest appearance. Show me the exercises, Part 1. & Part 2.
Other correction methods
Vacuum Bell - The vacuum bell is a device used to help the appearance of pectus excavatum by using air pressure to pull the sunken sternum outwards. Billy Zane was known to use this device before a photo shoot it works by place a large bell like bowl over your chest then slowly increasing the air pressure inside to pull the sternum forward.
Silicon Insert - Many people use skin colored silicon inserts to cover there sunken sternums to make clothing appear more natural.
Brace/Corset - A posture vest or corset can be used to correct your posture, as well as bring in those flared ribs.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
MoraG on March 07, 2018:
I've been like this since I could remember I don't remember the last time I took my shirt off infront of people other than family. This has become my biggest insecurity been thinking like this since middle school I am now 17 and stI'll am insecure
DM on July 12, 2017:
Thanks for sharing. Great write up.
Our daughter just recently developed it during puberty. Sometimes her chest hurts and other times it doesn't. Is that normal?
Pharmd870 on January 18, 2013:
Very nice site!
VictoriA on January 03, 2013:
Hi, i have this and i 23i just find out. Now i get why im thin with a big belly.If i have the surgery,it can help to make my stomach flat?
Chase on November 25, 2012:
The modified ravitch teqniqe performed at the mayo clinic is number one for pain and recovery if bothering heart and lungs
Chase Hinton on November 25, 2012:
I am currently 22 yrs old Iv had pe my whole life it didn't affect me until now and now its so intense I can barly get threw my days I'm iratated and in constant pain I am trying to get in the mayo clinic for the modified ravitch proceder its going to be tough if your kids have it when there 14 yrs old take them to a surgeon get a ct scan if it is depressing the heart get the much less invasive surgery while ur young it won't be nearly as much trouble and pain
Michael on September 12, 2012:
Hi, I'm 19 and have moderate Pectus Excavatum. I was born with it and have known I had it since about age 5-6. I just recently decided to look it up and figure out what it all completely is. I was just wondering if the fact that I can see my heart beat perfectly in my stomach area is a big problem? Also, I have 3 sets of floating ribs not sure if that is part of this. I also have a problem when I am standing or sitting too long then I lay down and my back has some Excruciating pain, Is this due to my lack of good Posture? Lastly I have been having random bouts of chest pain that occur at any possible time for about 2-5 minutes and it occurs randomly on my chest, sometimes on my left side and sometimes on my right, Is this part of it too? Sorry for all the questions, just trying to find some answers that I can't seem to find online. (Also my breathing has been a problem for years... but didn't kick up until my teenage years which I figure is due to the growth.) Thanks for all the other information though. Was very helpful.
Jayden on May 15, 2012:
I'm 15 and have a moderate case of Pectus excavatum and didn't really know much about it and I'm glade that there are other people I can relate too
Chris on March 26, 2012:
I always wondered why I had so many stretch marks on my back, now I know thanks to your post.
brian on March 20, 2012:
so i have a question that everyone that a lot of people want to know how much will it cost to have PE repaired if you don't have good insurance? Because everyday of my life i cant stand this deformity in the middle of my chest. i love to play football and skate and so much other things i wish i could do. i live in California and the question is..If my Pectus is server will my doctor from the city garentee the surgrey and if my family doesn't have good insurance would i have to keep paying to pay off the cost?
Chris on March 12, 2012:
I wanted to share my story with everyone because this is one of the most helpful PE sites I've ever found.
I'm a 26 year old male and have pectus excavatum that has always caused me problems. I have tried numerous times in the past to get a referral to an expert on the condition to find out what my treatment options are but I am continuously denied. A referral is required by my health insurance provider unfortunately. I have never been given any type of scan other than the x-ray taken when I went to the ER on Wednesday. I have repeatedly requested further testing over the years and I am constantly denied.
I got into my (former) family doctor's office Friday and was flat out denied any type of assistance beyond more pain pills. My problem has been getting worse over the years. It is at the point now where I need some type of intervention from an expert, but without a referral from a primary care physician, I am very much in the dark.
I work out regularly, stretch, do breathing exercises, and a lot of core work. Exercise is the only thing that offers any type of relief. If I go a couple weeks without exercising, my body feels like it got hit by a truck because of the pain in my chest and back.
I really think the problem is that the GPs I've seen simply have no idea what PE is. Friday, my doctor tried to tell me that it wasn't PE, but rather colitis, which I found out was an inflammation of the bowels (thanks, genius). He proceeded to prescribe more pain pills, same old story.
Has anyone else experienced similar problems getting a referral to a knowledgeable professional? I'm not even hell bent on the surgery, I just want to know what it's doing to my internal organs and I want to talk to a health care professional who can give me some options.
thismommy on March 09, 2012:
It appears that my baby girl (14 months old) has PE. I thought something was a little off with her chest when she was fairly brand new, but didn't really think anything of it until she was at a check up (for suspected hip dysplasia-which I was born with...thankfully she doesn't have that) and the doctor totally freaked out about how she was breathing. She wanted us to go straight to the ER because she was convinced the baby had RSV or something, but I didn't think anything was wrong. My oldest son had RSV at 4mo and you could tell he was sick, but my daughter was not sick. She was just like always. We went home instead to pray and research and eventually google led me to PE. We haven't had her formally diagnosed with it, but I'm certain that's what she has. I think she's absolutely adorable now, but I know that later she'll probably have her own feelings about how she looks. We plan on talking about it when she notices and reassuring her that God made her just the way He wants her, but it's ok too if she wants to have surgery to correct it. I don't think it's super deep at this point. I would guess from her outside sternum to her outside spine is probably about 3 1/2" difference if I put my hand around her. I will watch closely though as she gets older and starts getting really active. She's just started walking now. I do have a question, does PE affect the way you heal from chest colds? My oldest son has a tough time getting over them (he's actually sick right now), but my other daughter and my younger son get through pretty well. My baby hasn't really been sick yet, so I'm a tad concerned about how she will handle something more severe (we all had swine flu in 2009 when my youngest son was just a baby, but he barely sick).
Polly on February 25, 2012:
i was thinking of having the nuss done but im really worried if you can do sports with it in. I really like skateboarding, snowboarding and mountain biking but will i be able to do them?
bobby on January 30, 2012:
what is the easyiest/cost efficiant thing to do to fix pe
Coolboy95 on January 27, 2012:
Thank you for this! Now I can live with the fact that other people out there have it. I was constantly made fun of because of it and not confident.
skwiddaay on January 25, 2012:
At what age does it stop getting worse?
Frances on December 27, 2011:
My son just had this surgery on Dec 12 and it didn't go so well the surgeon hit his heart twice on the right side so they had to open heart surgery on him to fix the heart. This was really scary Thank god he is ok but he didn't want this big scar in his chest. But he is thankful to be alive
Ruan on December 12, 2011:
What haller index rating do you consider mild,moderate, and severe? The insurance companies consider 3.4 as severe
Guest 101 on November 30, 2011:
expectus thank you so much for keeping up with the posts for so long. after reading threw the extent of Q & A i feel better informed about my PE. Your dedication to the page has not gone unoticed thank you so much.
Chris on November 18, 2011:
Been noticing it in the past months, i think i have a mild case of it, im 18. Now though, i can feel like an indent in the middle of my stomach when I breathe in. It looks like my left side of my chest is bigger than the other, i have belly breathing. I smoke, does that increase chances of having the sunk chest? And are there doctors in Indiana that can perform the operations?
I been wanting to go to the doctors and im on medicade, but don't want to hear if its really bad or not...want to do it soon.
Thanks for the advice you've gave to many, helps a lot.
John on November 13, 2011:
Would love some advice to fix flared ribs ... I cannot get them to reduce in their flare.
I tried pull-over exercise using dumbbells but nothing happened :(
Katherine on November 10, 2011:
Hello! I am happy to have found this site. I am incredibly worried about my 10 year old son. For a few years now, people have commented about his sternum. It looks like a "dent" in his chest and you can see his ribs are very noticable. I always thought it was just the way his body is! Over the last few months he has been complaining of "rib pains". They happen a couple of times a day and he literally stops what he is doing because it hurts so much. My husband and I thought it was growing pains. I finally took him to the doctor who has refered him to a peadiatrician, but we have to wait 3 weeks to get in. All the research I have been doing points to him having pectus. I am wondering if a child is having this type of pain, if this is a huge concern. He is a very active little boy - plays hockey, football and any other sport. The rib pains seem to be the only thing affecting him. I am tempted to rush him to the ER as I am now really worried. Please comment to help a VERY concerned mom!!
t.mooney25 on November 08, 2011:
Ok so my son is 3 and also has PE. Could this effect his stomach at all??? He don't eat much at all and he says his stomach hurts after he's done.. His belly gets really big some times and looks like its gonna explode..
bishal on November 06, 2011:
hi i am a 23 yr old guy and my left rib slightly protudes out than the right but i think my chest is normal. Can u tell me what my real problem is and what is its remedy??
FeelsLikeTheOnlyOne on November 04, 2011:
I have PE. I am 24 and just NOW learned its real name. I was always told it was a something different. I feel sick, and discusting because I am a woman. Can you imagin how many times I have to see stupid woman with bikini tops on and know I will NEVER look like that. PA makes you look fat beacue of the ribs sticking out. I think about killing myself due to this. I have really bad BDD because of my PE. I will NEVER have confidence. I cannot afford getting it fixed.
I feel so ugly and unwanted. I am married, but that is only because by the grace of God I was given a pretty face. I will never feel happy
ben on November 02, 2011:
I think I have pe but it is only a little bit of my chest that is sunken and as soon as I tense my chest is completely flat o I have pe
expectus (author) from Land Downunder on November 01, 2011:
Brandon - do you notice his chest sinking in when he is not breathing, and does it look the same when he lies flat on his back?
for me as a kid it looked like my chest would sink as i breathed because i had a slight pot belly caused by the sunken sternum
expectus (author) from Land Downunder on November 01, 2011:
Tara - sorry to hear your son is having trouble breathing, when he is breathing in quickly do you find he is breathing into his chest or abdomen, if his pe is bothering him and he is trying to breath into his chest he may find it hard to get full breaths due to pressure from his sternum.
expectus (author) from Land Downunder on November 01, 2011:
Crazy DUDE - interesting if true :) but I do agree strong abs can definitely help correct pe or pc
John - I don't believe correcting your ribs will cause your sternum to sink further for me they are both involved as the ribs are move back into a neutral position the sternum is pushed out.
JJ - if its causing you pain its probably best to go see a doctor, if it hurts when you are stressed it may just be your sternum pushing on your heart.
Brandon on October 27, 2011:
Hi I have a two year old son and just noticed when he is breathing it looks like the center of his chest is caving inwards I told my mom and she said me and my other siblings when his age it looked the same my brother even worse she said cuz he's losing weight but I don't know can u tell me how to know forsure or things to notice be for I I bring him to a docter thank you and how do u tell mild from moterate to sever
Tara on October 26, 2011:
I just chuckled b/c the picture I found is at the top of this page. Sorry for that. Very informative.
Tara on October 26, 2011:
Hello, I have a few questions if you don't mind. My son is 6 and I've noticed over the last 2 yrs or so that his chest is sunken. I just found a picture of a child with PE and it lookes exactly like him. Our doctor has never said anything. Anyway, in June he started doing this weird breathing out quickly thing and we thought it was either due to a change in allergy shots or possibly a tic. He has never stopped doing this,but it did get a bit better for a short time. Now he's doing it constantly again. When this all started he said he felt like he couldn't get enough air,but seemed to play like his wild self. Well, today he had his shirt off and it occurred tome that it's gotten worse. I plan to take him to the doc, possibly even tomorrow if they can fit him in,but hoped to get some insight.
John on October 19, 2011:
Thanks for the reply m, well im not really looking forward to conduct a surgery. I just want to find a way to reduce that crap (flared ribs)..Thanks for the advice I might do that :)
m on October 19, 2011:
john- nope, my flared ribs slightly improved instantly after the nuss procedure was performed. Also, the appearance of having a normal chest helps make the flaring less noticeable. I had the same problem as you, the bottom of my ribs would show through my shirt. however, the fixing of the chest pushed pectus out and definitely made the flare less noticable. Since your pe is mild, im not sure if you are able to have the procedure done, but im sure that they have some sort of method of reducing the flare; i would talk to a thoracic doctor or surgeon, as they know what's best if you want to only fix the flare.
John on October 19, 2011:
m, glad to know you're PE has been fixed !! Did they give you any exercise to reduce flared ribs ?
m on October 19, 2011:
great article. i had a pectus for my entire life, and did not realize that it was a problem until i got checked out by a thoracic surgeon. Less than three months after that, i had surgery performed. It was a complete success, as my chest is now completely normal. Before the operation, i had shortness of breath and a constant cough (compression of lungs) which have dissapeared. My pectus was considered severe, which is why i underwent surgery. And to JJ, i'm not sure about the blood circulation or pain, but it would be best to get it checked out by a thoracic surgeon. they will take a CT scan to determine the severity of your pectus. And It seems that you are describing a flare in the bottom of your ribs, which i had as well. it is normal for a pectus patient to have. However, after surgery, the flare in my ribs has been significantly reduced. Hope I could help.
JJ on October 15, 2011:
I have pe and it dips in about an inch what would this be counsedered I have a little bit of the rib thing goin on and completely self-conscious about it too I think I have poor blood circulation cause my legs will fall to sleep if I sit on them wrong but my mom has poor blood circulation too. My chest also hurts some times and it is a sharp pain on the left side of my chest but usualy only when I am stressed out or mad idk if that's serious or not tho I am just curious what I should do about my condition.
John on October 12, 2011:
I have a mild PE, but the annoying feature is the flaring ribs right below my chest. I started working out in a gym recently and I figured out that my chest muscles will never grow big enough to cover the bumps (visible when wearing a shirt) that are caused by the flaring ribs.
I don't mind the depressed PE so much, but I also heard if I try to treat flaring ribs alone, the sternum may be pushed in even further. Can you please confirm that ?
Do you have any advice to how can I overcome this issue ?
Crazy DUDE on October 05, 2011:
I have Pectus Carinatum. I started noticing it back in 6th grade and got worse by 9th grade... anyways I've been lifting weights since 5th grade, chest got bigger, abs got tighter, and now I'm in 12th grade benching 280 weighing 140 and only 5'3" lol my sternum is really flexible now! I can shoot objects out of my chest! I can be either Evcavatum or Carinatum depending of how i flex my abs! people get so freaked out that i can shoot objects out of my chest sometimes up to 8 feet! My sternum looks normal now with the occasional bulge from falling asleep on my side by accident. I thank GOD for my deformity it has given me a great talent. :)
expectus (author) from Land Downunder on October 05, 2011:
Pippa - I know a few ppl who have gone through the same thing, with quite a bit of post op pain but they worked through it with stretches and exercises to strengthen chest and back muscles which we were overstretched and weakened during the surgery.
Martin - good to hear it Martin :) yeaa its really up to you whether its going to bother you and I know its hard to push through but in the end its not the most unusual deformity and we cant all be part of the herd, baaah :P , all the best
Martin on September 01, 2011:
This post helped a ton, and I can 100% relate, Im 15 and i have a moderate case of PE and it has definitely affected me over the years. Whenever I'd be playing sports or hanging out with friends I'd be embarrased to take of my shirt for games of Basketball etc. Now that im a bit older I can say that I've learned to deal with it and exactly as you said, just simply blowing off onlookers who stare at you like you're from another planet(which happens often) It still sometimes hard to deal with being different and being looked at weird but with age comes wisdom and I think I've been learning slowly to deal with it and not be embarrassed. Nonetheless, Great post!!!
Pippa on August 24, 2011:
My daughter had moderate to severe PE where her right ribs were curved inwards and growing back under. It only appeared when she started going through puberty and the older she got the worse the condition became. This affected her breathing and we consulted a dr when she started having heart pain. She also has scoliosis. She had the bar inserted in December 2008 when she was 15 yrs by Alex Auldist. She had some complications after surgery with a lung infection which needed more surgery and a drain to clear the fluid. She had chest and back pain on & off during the two years that the bar was in place. She had the bar removed in January 2011 by Joe Crameri. Her ribs on the right side have sunken inwards a little where they have overcompensated from being pushed outwards. Even so she is very happy with the outcome and no longer finds breathing difficult which was the reason she had the surgery in the first place. The reason I am writing is because she still suffers severe chest (around her sternum) and back pain (8 months post surgery) on and off and I was wondering if anyone else had pain once the bar was removed.
Roy on August 15, 2011: