How do I fix my sunken chest?: A comprehensive guide to pectus excavatum treatments

September 28, 2025 •

4 min read

Pectus excavatum, also known as sunken chest, is one of the most common congenital chest wall deformities. For those asking, 'How do I fix my sunken chest?', it's important to understand the various treatment paths, ranging from non-invasive therapies for mild cases to surgical correction for more severe conditions.

Quick Summary

Options for fixing a sunken chest depend on severity, ranging from cosmetic solutions like fillers or targeted exercises for mild cases to more significant interventions like vacuum bell therapy or surgery (Nuss or Ravitch procedure) for moderate to severe conditions.

Key Points

Surgical Repair for Severe Cases: The Nuss and Ravitch procedures are highly effective surgical options for moderate to severe pectus excavatum, especially if symptoms like heart and lung compression are present.
Vacuum Bell for Mild-to-Moderate Cases: This non-invasive device uses suction to lift the sternum over time and is a good option for children and teens with less severe conditions.
Exercise and Physical Therapy: Targeted exercises can improve posture, strengthen supporting muscles, and minimize the visual impact of a sunken chest, particularly in mild cases.
Cosmetic Fixes Available: For those primarily concerned with appearance, dermal fillers or silicone implants can be used to fill the indentation, offering a cosmetic solution without addressing underlying function.
Professional Diagnosis is Key: The best course of action depends on the severity of the condition, which can be evaluated by a thoracic surgeon using physical exams, imaging, and measurements like the Haller index.
Recovery Varies by Treatment: Non-surgical methods require long-term consistency, while surgical recovery involves a period of limited activity and pain management for several weeks.

Understanding the 'Sunken Chest' Condition

Before exploring treatment options, it's crucial to understand what causes a sunken chest, medically known as pectus excavatum. This is a congenital condition resulting in an atypical development of the breastbone and ribs, creating a caved-in appearance. While its exact cause is unknown, it can run in families and often becomes more prominent during adolescent growth spurts. Mild cases may have no physical symptoms, but moderate to severe cases can compress the heart and lungs, causing symptoms like shortness of breath, chest pain, and fatigue.

Non-Surgical Treatment Options

For individuals with mild pectus excavatum or those who wish to avoid surgery, several non-surgical approaches can help improve appearance and manage symptoms. These methods focus on strengthening the muscles around the chest, improving posture, or using external devices.

Therapeutic Exercises

Physical therapy and targeted exercises can improve posture and strengthen the core, back, and chest muscles, which can minimize the visual appearance of the indentation and help with related posture issues.

Effective exercises include:

Deep Breathing Exercises: Diaphragmatic breathing can help expand the ribcage and alleviate chest tightness.
Chest Stretches: Gently pulling clasped hands upward behind the back helps stretch the chest muscles.
Posture Correction: Exercises like 'wall angels' and 'chin tucks' can help maintain proper alignment.
Strength Training: Activities like pushups, dumbbell rows, and chest flies can build and strengthen the pectoral and back muscles.

Vacuum Bell Therapy

Vacuum bell therapy is a non-invasive treatment primarily used for children and adolescents with mild-to-moderate pectus excavatum. It involves placing a suction-cup device on the chest wall for a prescribed period each day, which gently pulls the sternum forward over time.

Key considerations for vacuum bell therapy:

Requires consistent, long-term use (often 12-15 months or more).
Effectiveness depends on the patient's age and chest wall flexibility.
Not suitable for those with heart or bleeding disorders.

Cosmetic Fillers or Implants

For purely cosmetic improvements in mild cases, and particularly in adults, a healthcare professional can place silicone implants or dermal fillers to fill the sunken area. This is not a functional fix but can address concerns about appearance.

Surgical Treatment Options

For moderate to severe pectus excavatum, especially if symptoms like heart or lung compression are present, surgical correction is often the most definitive and effective treatment.

The Nuss Procedure

The Nuss procedure is a minimally invasive surgery and the most common technique for repairing pectus excavatum.

The process typically involves:

Making two small incisions on either side of the chest.
Threading a custom-curved metal bar under the sternum.
Rotating the bar to push the breastbone outward.
The bar remains in place for two to three years before being removed in a minor outpatient procedure.

The Ravitch Technique

This older, more invasive surgery is now used less frequently than the Nuss procedure.

The process includes:

Making a larger incision down the center of the chest.
Removing deformed cartilage.
Repositioning the sternum and using surgical hardware, like metal struts, to hold it in place.

Treatment Comparison: Surgical vs. Non-Surgical


Feature	Surgical Correction (Nuss/Ravitch)	Non-Surgical Methods (Exercises/Vacuum Bell)
Effectiveness	High for moderate-to-severe cases; definitive correction of the deformity.	Varies by severity; can improve posture and appearance for mild cases but does not structurally correct the deformity.
Invasiveness	Minimally invasive (Nuss) to invasive (Ravitch); requires anesthesia and hospital stay.	Non-invasive; performed at home or with a physical therapist.
Target Patient	Adults and teens with moderate to severe cases, especially those with symptoms.	Children, teens, and adults with mild cases or those with cosmetic concerns.
Recovery	Several weeks of limited activity; pain management is necessary.	Minimal downtime; consistent, long-term commitment required.
Risk Profile	Includes risks of any surgery (infection, hardware issues).	Lower risk profile; potential for skin irritation from vacuum device.

The Role of Posture and Core Strength

Regardless of the treatment path, a strong core and good posture are essential for managing pectus excavatum. By strengthening the muscles that support the spine and chest, you can reduce the strain on your ribcage and minimize the visual impact of the chest wall indentation. Proper posture ensures that your internal organs have the maximum available space, which can help mitigate any compression issues caused by the deformity.

Considering Your Options

Choosing the right path depends on the severity of your condition, your symptoms, and your personal goals. Consulting with a thoracic surgeon or a pectus excavatum specialist is the best course of action. A doctor can accurately diagnose the severity of the condition, often using imaging like CT scans to calculate the Haller index, a key metric for surgical consideration. A multi-disciplinary team, including a cardiologist and pulmonologist, may also be involved to assess any impact on heart and lung function. For comprehensive information on the condition and treatment options, visit the Mayo Clinic's dedicated page: Pectus Excavatum - Diagnosis and Treatment.

Conclusion: Personalizing Your Treatment Plan

Whether you opt for a non-surgical approach like exercise and vacuum bell therapy or a surgical correction like the Nuss or Ravitch procedure, the goal is improved quality of life. For mild cases, focusing on posture and strength can be very effective, while for moderate to severe cases, surgery offers a durable and comprehensive solution. The key is to receive a proper evaluation from a medical professional to determine the best course of action for your unique situation.

Frequently Asked Questions

A sunken chest, or pectus excavatum, is a congenital condition of unknown cause that involves the atypical growth of the breastbone and ribs. It often becomes more noticeable during adolescent growth spurts.

While exercise cannot fully correct a sunken chest, it can strengthen surrounding muscles, improve posture, and enhance overall body image, which can significantly reduce the deformity's visual impact.

No, surgery is not the only way. Treatment options range from non-invasive methods like vacuum bell therapy and targeted exercises to surgical procedures such as the Nuss or Ravitch techniques, depending on the severity of the condition.

Vacuum bell therapy uses a suction-cup device placed on the chest to create negative pressure that gradually pulls the sternum forward. It requires daily, consistent use over many months to be effective for mild-to-moderate cases.

Doctors often recommend waiting until after an adolescent's main growth spurt to consider surgery, as the bones are still flexible. However, surgery can be performed in adults as well, especially if symptoms are present.

For very mild cases, focusing on posture and general fitness at home may provide improvement. However, it is always recommended to consult a doctor for a proper diagnosis and to discuss the most appropriate treatment plan for your specific condition.

Surgical procedures for pectus excavatum, like any surgery, carry risks such as infection, pneumothorax, and issues with the implanted hardware. Post-operative pain is also a consideration, though modern techniques like cryoablation help manage it.