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Pectus carinatum is a condition of the front of the chest and is essentially the opposite of pectus excavatum.
The chest bows outward due to abnormal growth of the cartilage on either side of the sternum. The defect can be symmetric, meaning it affects both sides in the same way, or it can be asymmetric and be more pronounced on one side. Males are more commonly affected than females.
Pectus carinatum usually appears during puberty and tends to worsen as patients go through growth spurts.
Determining a Diagnosis
Patients and families who are concerned about a chest wall abnormality should make an appointment with one of our pediatric surgeons who specializes in surgical and non-surgical treatment of chest wall abnormalities.
During the first appointment a complete history and physical exam will be performed. Patients are also tested for any metal allergies as both surgical and non-surgical treatments involve metal parts touching the skin.
Correction of pectus carinatum is performed both surgically and nonsurgically, although nonsurgical correction is the preference of most patients and families.
Non surgical correction is achieved using a special type of brace that is fitted to each patient. Measurements for the brace are taken during the first consultation. Patients return to clinic when their brace arrives, and the brace is custom fitted to their chest. The length of time a patient will need to wear the brace depends on the severity of the carinatum and the patient’s adherence to wearing the brace.
Patients are instructed on breathing exercises and on how to test the skin to ensure the brace is not too tight. The brace is not worn during exercising or physical activity.
Patients are seen intermittently for adjustments and can expect significant improvements even during the first couple of office visits.
Individual patients may not be candidates for bracing, but instead may require an operation for correction. The operation that is performed is called the Ravitch procedure. A lower chest incision is made, and the protruding cartilages are removed. The sternum is divided and brought into a more normal position. The cartilages grow back over time, but grow in a more normal position.
After surgery the patients are followed by the Anesthesiology Pain Management Service to ensure that they are as comfortable as possible. A small drain inserted during the operation, is removed prior to discharge. Patients are seen back in the office for follow-up and are instructed to avoid contact sports until their chest is fully healed.
Schedule a Consultation
All patients at Texas Children’s are treated in an individualized and family-centered manner. Our specialists provide cutting-edge treatment to achieve the best outcomes. Schedule your appointment by calling 832-822-3135.