What is Pectus Excavatum - Growing up with PE, Causes, Surgery and Exercise
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I have pectus excavatum and I'm writing this hub to help people understand what pectus excavatum is, what it involves and my general experience with the chest deformity and its overall effect on daily life.
Pectus Excavatum is the medical name for a chest deformity and is also referred to as pigeon and funnel chest. The chest deformity is distinguished by a sunken sternum accompanied usually with flared ribs. Pectus excavatum will also cause some of your internal organs to be displaced for example your heart could be pushed up or down or more to the left than normal its only when your heart is being obstructed or pushed against that pectus excavatum 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 and real reason is still not known. Some believe it to be poorly coordinated bone structure others believe its overgrowth of bones in birth. Other researched reasons are a lack of zinc and magnesium in bones which could possibly cause them to bend unnaturally.
For me it was simply that my father and his father also had mild pectus excavatum and passed it down to me. I was the only one who got it and it seemed to skip my brother for some reason. So the genetic reason is the most common and if you find you have a slightly sunken sternum someone in your family probably has the same.
Growing up with a Chest Deformity
The most common things people with P.E will experience when growing up is low self esteem and a lack of confidence. This is due to being embarrased to take off your shirt in public as people will often stare at you and think your some sort of freak.
As a young kid I experienced this as the condition made me appear even skinnier than i actually was and made me look qutie malnurished when infact I ate like a horse and played basketball 3 times a week.
When I think about it , it wasn't that bad you just have to try and not let all the stares bother you and be confident. Who cares if your chest doesn't look like every other sheep:P its unique and if its not giving you any real trouble its something you can definitely live with and be happy.
Severity of the condition
There are three main levels of pectus excavatum these are as you can expect 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 dont 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.
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even billy has P.E
Correcting your Pectus Excavatum
Surgery Correction
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.
Exercise Correction
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 hubs 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 aswell as bring in those flared ribs.
Until next time :)
Thats it for now a basic overview I will publish some more hubs soon on
- Exercises to help your chest deformity (specific exercises to try)
and - Pectus excavatum surgery ( discuss surgery options, real cases e.g) A good website discussing surgery options and issurance cover is www.pectuslist.com it also has an updated list of doctors that perform P.E surgery around the world.
- Pectus List - chest deformity help
PECTUS LIST - Find a Pectus Doctor on our Pectus Doctor Databse - Surgery Nuss Procedure Booklet ,Insurance Pectus Excavatum, tips and help getting insurance cover for pectus carinatum or pectus excavatum, pectus correction exercises, appeals, surger
Lots of other Pectus Excavatum related HUBS
- Pectus Excavatum Repair Part 1
This hub is about pectus excavatum repair and I will share some exercises and things you can do to improve the appearance of your chest wall without going for the surgery option. As the surgery can take a... - Pectus Excavatum Repair Part 2
This is Part 2 a continuation from Pectus Excavatum Repair part 1 and this hub will discuss specific exercises you can try to help your pectus excavatum condition.The main question in managing pectus... - Pectus Excavatum Surgery Introduction
Pectus excavatum is a chest disorder that effects approximately one in every 1000 people. The deformity is easily recognized by the concave , funnel shaped chest. The sunken sternum can apply pressure on... - Pectus Excavatum Surgery Procedure
This hub will a continuation from my last hub which was an introduction into pectus excavatum surgery this hub will go into the detail of the actual surgery procedure including graphic images. 1. The first... - Pectus Excavatum Insurance & Surgery Tips
I’m currently running a website on Pectus Excavatum and also have the Pectus Excavatum chest deformity and a lot of people ask me for tips on getting insurance cover as well as how to approach the whole... - Pectus Excavatum PostOperative Care
This hub will go through the details of post operative care. The things you should do after having the surgery to speed up recovery and to get the full benefit of the pectus excavatum surgery. Patients... - Pectus List Blog and Information Centre
Pectus list, all things related to Pectus Excavatum and Carinatum, articles on P.E correction through exercise and surgery. Aswell as tips on finding the right doctor aswell as the pectuslist , list of doctors in the world performing pectus excavatum
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Comments
Glad it helped you:) Good work identifying it at such a young age too, Make sure your child maintains good posture it can greatly affect the appearance of his/her chest:)
very good post buddy.
i have a moderate/severe case, and completely agree with the part about slowly developing confidence and being afraid to take off your shirt.
My baby had his 4 month check up with his pediatrician and we have decided to have a specialist evaluate his PE so there is a baseline to compare to as he develops and grows. And I will take your advice regarding posture.
How do you know during infancy how mild or severe this PE will be?
Hi , Sandy thats a very hard thing to tell because it does usually get worse as you get older, not really worse but more noticeable as you grow.
A really severe condition would present other symptoms like breathing trouble and chest pains and you should keep your eye out for those,
during infancy pe may sometimes look quite severe, I remember when I was young when i would sit down PE would cause me to have a pot belly sort of look making the pe appear deeper than it actually was
hi there my son just turned 8 months old yesterday and he also was born with PE , im a little concerned with his breathing at night when he sleeps he breaths but then he'll stop for a few secs not exhaling or inhaling but his chest still moves up and down , ive thought it was to do with his chest but the doctor i seen said no he beileved it to be caused but a head cold he suffered with, is there any info you could add to this concern, thanks
Hello, I understand you concern , you got to keep a close eye on those young ones from what you describe the only explanation I could give for stopping inhaling and exhaling is that because of the P.E it is hard to get in a nice deep breath and he may be getting very shallow breaths, when you noticed him not breathing did you put your hand infront of his face to see if you could feel any air.
I have also heard of cases were mucus or reflux can sometimes obstruct your babys breathing passage for a short peroid so this may be whats happening if he did have a cold not too long ago. How does your son appear at these times when he stops breathing, does he appear pale or anything like that
thanks 4 replying so quick, ya ive checked for air but theres none its only for a short sec or two and i usually nudge him and say breath hehe and it could very well be due to his cold and being stuffed up i just out of 5 kids have never noticed any others ever doing such a thing when sick and cause of his PE and lack of info on the topic it concerned me i think ill end up seeing another doctor on this issue just to rest my mind , my son looks and acts like a very health happy little guy so as far as pale and stuff no he looks great its just when he sleeps at night..weird!when i had him 8 months ago no doctor even told me he had PE i at first thought nothing of his chest thinknig it was just my hormones passed through him giving 'Cash" my son the appearence of breasts but after a few days i started questioning it and at his 6 week check up is when i asked the doctor about his checst and all i was told was what it was called and they asked me if his breathing was good and back then i never noticed they way he slept so i guess thats why im a bit concerned now ,i just wanted to thank you soooo much for posting all your info on PE its been a great help
My pleasure mommaof5:) good idea getting another doctors opinion on it & goodluck with all your kids :) all the best
Expectus, you're really providing a good source of information for all of us - thanks! I would like to know if there is any evidence that the target exercises, vacuum bell, and corset/braces eventually make permanent changes/corrections in moderate pectus excavatum and flared ribs?
thanks for the comment, I am not sure how permanent these things are because most of the time you will have to be very consistent and as you achieve a level your happy with , every now and then keep up a maintenance program to keep your desired look.
here's a link to some braces and results
http://www.orthopectus.com.br/fcases.htm
I have tried the vacuum bell myself and see it as a more of a temporary solution , and to be honest i think it puts way to much pressure on your heart and surrounding organs,
your best bet is exercise and bracing, and i would have to say bracing will get you the results a lot quicker. Using only exercise can take years of work so many people give up before they start to see results.
goodluck:)
Thanks for the quick response. I had stumbled onto Dr. Haje's site yesterday and it is a wealth of info and encouragement even for someone as old as me (38). I think I will fashion a brace like the Dr. Haje one and reel in my flared ribs although I will be guessing as to how tight to maintain the brace and how far to bring the ribs in. I am currently lifting weights 4 days/week and am really motivated. I did notice someone posted a little info at various blogs that you may or may not have seen:
Here are a few things you can do to improve your pectus if you do not want surgery.1. You can get the vacuum bell (made in Mannheim, germany) but pretty easy to get. look up Dr. Klobe. Pro's= Helps most peoples chest return to a more normal state. Con's= doesn't work for everyone and it leave a reddish pigment on some peoples skin but that goes away.Here's a WIKI on this http://en.wikipedia.org/wiki/Vacuum_bell_(medicine 2. Some things you can do with your work outWhen you do your ab routine put a regular belt (one that cannot loosen as you do crunches) around the area where your ribs protrude and make sure it is level all the way around your body. This will put your body in great posture and will enable your upper abs to benefit a workout. You can expect to see results in about a month I'd say take a picture of yourself to compare in a month. You will feel your upper abs sore as hell probably for the first time within the first or second workout. 3. Do bridges, the thing they made you do when you were in like 3rd grade when you put your hands next to your head an bow your body up. This will stretch you muscles and help with gains and for some reason helps really well with PE and your back muscles. (MAKE SURE TO HAVE SOMEONE HELP YOU YOUR FIRST FEW TIME YOU CAN HURT YOURSELF VERY EASY DOING THIS) do about 15 of these a day holding for 10 seconds. One of the most important upper body muscle groups to work is your back. Training your lats gives you a wider appearance from the arms down. It's all about depth. The wider your upper body is, the less obvious your pectus seems. Don't get me wrong, your haller index (depth of the dent) won't improve. Having a muscular back also helps force you to stand upright, and we all know what a great posture can do for the appearance of PE.Another very important muscle group to train is your core. Having a slim stomach goes a long way, especially if you have the "pot bellied" appearance often associated with Pectus. This isn't true for all cases, but I've found that training my abs hard along with a very healthy nutrition intake actually helped the appearance of the flared ribs. My theory is that the muscles actually pulled the flared ribs inward.
There is some good info there thanks for adding it, and a brace is a good idea, i use a homemade one myself sometimes, remember to start off slow bringing the ribs back gradually you will feel pretty uncomfortable if its too tight i have tried it and i used to wear it 24 hours a day. I tried sleeping with it but if its too tight it just slips off my ribs.
Many thanks and I will continue to exercise and research as much as I can on this subject.
My pleasure, goodluck repairing your chest:) keep me posted if you make any breakthroughs
hmm any idea how did u make your own belt?? isit just a strap or did u put somehintg else
hmm any idea how did u make your own belt?? isit just a strap or did u put somehintg else
Hi, well i ended up buying a cheap back brace type thing a nice strong one with velcro then got to small rubber pads and put them on the area where my ribs poke out , to help push them in, hope that helps
ok thanks!
Hello, can I ask if even a 21 year old like me can have a surgery?it is too late for me or what?
Hi daniel, no its not too late at all I went to see a specialist around that age and he said he can pretty much do the surgery on any age , as its considered more of a cosmetic surgery so there's no reason you cant get it done if its bothering you.
Goodluck , best to get in contact with your nearest orthapaedic surgeon or pectus excavatum specialist
hi, anyone know of anybody getting plastc surgery for pe, what surgeons in Australia do this and how much?
Hi, i've heard of people getting silicon implants to cover up the dip in the chest, but I would think any plastic surgeon would be able to do that, unless u can talk to a orthapaedic surgeon about it first.
hi, thanx for reply, this is the 1st time ive talked to any1 about my pe, im 32. im in the mild/moderate group and want to fix it for aesthetic reasons mainly, although my fitness levels suffer i can live with that, its just annoying when im more exausted than people far less fit than me during sport activities, esp. snowboarding, something to do with the high altitude air makes it worse i think :P. anywho, just wondering what the costs roughly are for uninsured proceedures, im willing to pay for it, i dont want to go through all the hassel and tell the world while im doing it lol.
hey, no problem , high altitude probably doesn't help as most of us p.e'ers seem to have trouble taking in full deep breaths due to our pushed in sternums, In australia I think basic medicare would pay for some of it and it would up around the 10,000 mark.
What state are you in as there is a specialist in melbourne dr alex auldist who has been doing the surgery for years I've actually talked to him and he has no problem doing it for cosmetic reasons, he was actually the one who brought the procedure to australia.
hey, what proceedure does dr alex do, nuss? i dont think id get that done, it looks a bit full on, and i read older patients' pe might return, that would be a waste of money, sounds like he has alot of experience with it though. i think an implant would be the go, do you have any info on that?, that would prolly cost around 10G too hey, just like getting a boob job! :D thanx again.
hey, yea alex only does the nuss procedure, I think if your looking for a boob job:P you can pretty much go to any plastic surgeon in your area but will be quite expensive.
It should be a pretty simple procedure really, its just like a silicon implant a friend of mine had it done and I think he just went to the nearest plastic surgeon:)
Hey, have u seen ur freinds implant job, is he happy with it, can u tell if he has an implant?
do u know of any before/after pics of this proceedure anywhere on the net?
Thanx
hey spoonman, yea i have seen it looks normal to me , i think its a pretty simple procedure they just make a cast and insert it.
only site i found that was anything close was pec implant site its pretty much the same thing http://www.bodyimplants.com/pec_implants.html
my little step brother has this, sadly though he wants to play football and his is severe enough that he will have to get surgury before he can even think about taking(or giving) a tackle to the abdomen
sorry to hear about your step brother, I was told the same thing about playing sports. Pretty much forget it they said.
I hope he gets the surgery and is able to play football
Here's my Question.
Does it Handicap your Cardio at all? will you not be able to run as fast or far because you can't hold enough oxygen in?
anything like that?
some people say yes others say no. depends on how severe it is an mainly about how much it pushes on your heart causing poor blood flow and less oxygen getting to your organs while your running.
its a common thing for people with PE , to complain about a lack of fitness and it can be partly to the fact that we find it hard to take in a full deep breath because of our sunken sternums.
expectus, Thanks for all the advice although I do have a couple questions.Im a 15 year old boy, I have severe PE and a pretty big case of flared ribs. I am going to get surgery for my PE (nuss procedure) but I want to know if that will correct my flared ribs?. Flared ribs are also very annoying so I am really hoping that surgery will correct both. Also I have a pretty mild case of scoliosis ( I suspect I got it from hunching over all the time so no one would notice my PE). Will the surgery help with that also?. I cant imagine myself wearing a brace even while I have a bar in my chest.
Thx for the info :)
Hi david, getting the nuss surgery to return your sternum to a more normal level will usually result in your ribs also being brought in to a more normal position.
I dont know how much the surgery will help your scoliosis I think you would have to see a spine expert but hopefully you will be able to stand up nice and straight once you have your surgery and fix that aswell.
thank you. you have been very informative :)
no problem david :) glad I helped
hello i have a just turned 12yr old son that just hit a growth spurt and has mild pe..i had taken him to his dr yrs ago about this and was told that it was more cosmetic than anythin else..well two days ago my son was playin and started to seize up and fell over w/loss of consciousness for about a min..i took him to the hospital and they pretty much did nuthin but said he'd be fine but my feelin is that his grownth spurt has triggered sumthin w/his pe..is this possible? i'm takin him to his dr. again to question him as well but i dont know what to think..this was a scary first and i'm worried about my son now.
Hi linda, yea those doctors always say its simply cosmetic but without proper scans and tests I'm not how they can be sure the sternum is not pushing on vital organs.
If your son has no other medical conditions that could cause him to seize up the only thing I could think of is a lack of oxygen or poor blood flow do to the sternum pushing on his organs.
Does he have trouble breathing in general? is getting enough oxygen throughout the day and while he sleeps
I'm a boy in the age of 13 and I have really mild pectus excavatum.My friends can see it and I am very self conscious about it. I also heard it gets WORSE as you age, and I'm also very worried about that too. I really want to put surgery as my last option. Should I purchase a vacuum bell or something to fix it? PLEASE! What can/should I do?!
Thank You.
Hi kev, main thing to make sure is that you maintain good posture, most people including myself had poor posture which made our chests look worse.
A vacuum bell is more of a temporary fix unless you are very consistent and even then I believe it would take years, and it can put a bit of a strain on your heart. Best bet is exercises for PE and wearing a posture vest, strengthening core/abs.
breathing exercises, yoga , improving general mobility can help
I have a severe case of Pectus Excavatum and I had to have a surgery when I was 7 to correct it. They didn't want to do the surgery before I was finished growing, but it was REALLY bad to the point that it was effecting my heart and lungs. Now I am 28 and since then I have obviously finished growing, but because I was still growing after the procedure it has sunken in again. Even after the initial surgery I would say mine is still a severe case because it is in a few inches still. I have had issues with it my whole life and I have been looking to get it repaired again. I still won't take my shirt off in public and would one day like to be able to do so without drawing attention.
I hear this alot with people having the surgery done early in there lives, I think because as a kid your not really aware of maintaining good posture and sticking to the post-op exercises the doctors tell you to do.
even with a good maintenance program sometimes you can't do much about it as you get older as it does get much deeper, as it did for myself.
heather says:
8 months ago
my 4 monthold has mild pe and this article is great for people who need more info on the subject. thank you