What is a pigeon chest posture? Your guide to pectus carinatum

September 28, 2025 •

4 min read

Affecting approximately 1 in 1,500 children, pectus carinatum is the medical term for what is a pigeon chest posture? This condition involves the sternum and ribs protruding outward, and while it often has cosmetic implications, it is also important to understand its causes and treatments from an authoritative health perspective.

Quick Summary

Pectus carinatum, known colloquially as a pigeon chest, is a chest wall malformation where the breastbone and attached cartilage grow abnormally, pushing the chest outward. It can be present from birth but often becomes more noticeable during adolescent growth spurts. Causes are not always known but can include genetic factors and associated syndromes. Management options range from observation to non-surgical bracing and surgical correction.

Key Points

Definition: Pectus carinatum, or pigeon chest, is a chest wall deformity where the breastbone and ribs protrude outward due to cartilage overgrowth.
Commonality: The condition is not rare and affects approximately 1 in 1,500 children, with symptoms often becoming more prominent during puberty.
Bracing: Non-surgical bracing is a highly effective treatment for adolescents, gradually reshaping the chest wall over time with consistent use.
Surgical Options: Severe cases or adult patients may require surgical correction via procedures like the Ravitch procedure to remove excess cartilage and reposition the sternum.
Psychological Impact: Beyond physical symptoms like chest pain or shortness of breath with exercise, the condition can significantly affect body image and self-esteem, especially in teenagers.
Diagnosis: A diagnosis involves a physical exam, and may include imaging like chest X-rays or CT scans to assess severity and rule out other issues.
Associated Syndromes: While often sporadic, pectus carinatum can be associated with certain genetic syndromes like Marfan and Noonan syndromes.

Understanding the Pigeon Chest Posture (Pectus Carinatum)

An estimated 1 in 1,500 children are born with pectus carinatum, the medical term for what is a pigeon chest posture? This condition involves the sternum and ribs protruding outward, and while it often has cosmetic implications, it is also important to understand its causes and treatments from an authoritative health perspective. Pectus carinatum is a structural chest wall deformity caused by an overgrowth of cartilage connecting the ribs to the breastbone. While it can exist from birth, it frequently becomes more pronounced during puberty's rapid growth phase, particularly in males. This protrusion can range from mild to severe and may be symmetrical or asymmetrical.

Causes and Associated Conditions

For many individuals with pectus carinatum, the exact cause is unknown. However, research points to a mix of genetic and developmental factors. The condition often runs in families, suggesting a hereditary link. About 25% of affected individuals have a family history of chest wall deformities. In some cases, pectus carinatum can be associated with certain genetic syndromes or other connective tissue disorders. These can include:

Marfan syndrome
Noonan syndrome
Cardiofaciocutaneous syndrome
Morquio syndrome
Homocystinuria

Additionally, some children who undergo open-heart surgery, which involves splitting the sternum, may develop the condition later in life. It is also important to note that up to half of children with pectus carinatum may also have some component of pectus excavatum, where the chest is sunken rather than protruding, sometimes even on opposite sides of the chest.

Signs, Symptoms, and Diagnosis

The most obvious sign of a pigeon chest posture is the outward bowing of the breastbone. For many, this is the only symptom. However, in some cases, patients may experience other issues, especially during and after exercise. Possible symptoms include:

Physical Appearance: The visible chest protrusion, which can be a source of cosmetic concern and self-consciousness, especially in teenagers.
Chest Pain: Discomfort or pain in the chest wall, ribs, or back, which can occur with physical exertion or during growth spurts.
Shortness of Breath: Difficulty breathing, particularly during exercise, due to the chest wall's reduced flexibility limiting lung expansion.
Fatigue: Feeling more tired or having less stamina during physical activity compared to peers.

Diagnosis is typically straightforward and begins with a physical examination by a doctor, who will review the patient's medical and family history. To confirm the diagnosis and assess the severity, additional tests may be ordered:

Chest X-ray: Provides an image of the chest wall to determine the extent of the deformity.
Computed Tomography (CT) Scan: Offers a more detailed, cross-sectional image of the chest to help evaluate heart and lung compression.
Magnetic Resonance Imaging (MRI) Scan: Used to assess the soft tissues and other internal structures in and around the chest.
Pulmonary Function Tests: Measure lung capacity and function to determine if there is any breathing impairment.

Treatment Options: From Bracing to Surgery

Treatment for pectus carinatum depends on the patient's age, the severity of the condition, and its impact on their physical and psychological health. The main treatment pathways are observation, non-surgical bracing, and surgical correction.

Non-Surgical Bracing

Bracing is a highly effective, non-invasive option for adolescents whose bones are still malleable. This method is similar to how dental braces realign teeth. A custom-made, lightweight chest wall brace is worn for a prescribed number of hours each day, applying gentle pressure to the protruding area. The goal is to reshape the chest wall over several months or years. Consistency is key for this treatment to be successful.

Surgical Correction

Surgery is typically reserved for severe cases, those where bracing has failed, or for older individuals whose skeletons have matured. The most common surgical procedure is the Ravitch procedure, which involves an incision to remove the overgrown rib cartilage and reposition the sternum. In some cases, a supportive bar may be placed temporarily to maintain the new chest position.

Pectus Carinatum vs. Pectus Excavatum

It's useful to understand the differences between the two most common pectus deformities. The comparison below highlights their key features:


Feature	Pectus Carinatum	Pectus Excavatum
Appearance	Breastbone and ribs protrude outward.	Breastbone and ribs appear sunken or caved in.
Nickname	Pigeon Chest	Funnel Chest
Underlying Cause	Overgrowth of rib cartilage.	Overgrowth of rib cartilage.
Prevalence	Less common. Occurs in 1 in 1,500 people.	More common. Occurs in 1 in 400 people.
Main Treatment for Adolescents	Non-surgical bracing.	Surgical repair (Nuss procedure).

Addressing the Psychological Impact

The psychological impact of a visible chest wall deformity, especially during the self-conscious teenage years, should not be underestimated. Concerns about body image and self-esteem are very common. It is crucial to address these concerns and provide emotional support. For some, the cosmetic correction provided by bracing or surgery is the primary motivation for treatment, leading to improved confidence. Open communication with a healthcare provider and mental health support can be valuable components of a holistic treatment plan.

Conclusion

Pectus carinatum, or pigeon chest, is a chest wall deformity with various causes, from genetic predispositions to growth-related factors. While it can cause cosmetic and, in some cases, physical issues, there are effective diagnostic tools and treatment options available. Understanding the condition is the first step towards managing it effectively, whether through observation, bracing, or surgical intervention. For more comprehensive details on chest wall deformities, consulting with medical experts is recommended, for example, through a reputable institution like Johns Hopkins Medicine. Addressing both the physical and emotional aspects of the condition is essential for a positive outcome and improved quality of life.

Frequently Asked Questions

For most people, a pigeon chest is not a serious medical issue. It is primarily a cosmetic concern. In severe cases, however, it can cause physical symptoms like shortness of breath during exercise or chest pain, and it can have a significant psychological impact on self-esteem.

A pigeon chest does not typically go away on its own. While it can appear to worsen during growth spurts, it is a permanent structural deformity unless treated. Treatments like bracing can correct the condition during adolescence, and surgery can address it at any age.

Chest bracing is very effective for correcting a pigeon chest, especially when used in adolescents whose skeletons are still growing. The success rate is high when patients are compliant and wear the brace as prescribed for the necessary duration.

Yes, surgical correction for pectus carinatum, like the Ravitch procedure, is generally considered safe. As with any surgery, there are risks, but it is a standard procedure performed by experienced surgeons. Surgery is usually reserved for the most severe cases or when bracing is not an option.

Recovery from pectus carinatum surgery can take several weeks. Patients will likely experience pain and stiffness initially, which can be managed with medication. Physical therapy is often recommended to help restore strength and chest wall flexibility. The timeline for full recovery varies based on the individual and the extent of the surgery.

In most cases, a pigeon chest does not affect heart function. Unlike pectus excavatum, which can sometimes compress the heart, pectus carinatum pushes the chest outward. If a patient experiences related symptoms, such as shortness of breath with exercise, a medical evaluation can determine if the condition is impacting heart or lung function.

Yes, adults can have a pigeon chest corrected, though surgical options are more common as their bones are no longer growing. The Ravitch procedure can effectively correct the deformity in adults, though recovery may be more involved than for younger patients.