Pectus Carinatum

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What is pectus carinatum?

Pectus carinatum (PECK-tuss care-uh-NAW-tum) causes the chest to bow outward. It happens because of a defect in the tough connective tissue (cartilage) that holds the ribs to the breastbone (sternum).

The opposite condition, called pectus excavatum, makes the cartilage grow inward, causing a dent in the chest.

Symptoms of Pectus Carinatum

The main reason families seek treatment is that their child doesn’t like how their chest wall looks. Pectus carinatum makes the chest bow outward.

Most children do not have other symptoms. A few may have mild pain. If the chest wall sticks out a lot, it may hurt a little when a child lies on their chest.

Pediatric General and Thoracic Surgery at Seattle Children's

When it comes to your child’s health, experience matters. Our surgical teams have the skills to do it right the first time and to care for children with the rarest conditions.

Diagnosing Pectus Carinatum

During your first visit to Seattle Children’s, the doctor will:

Ask about any symptoms
Check your child’s chest wall to see if there are other problems

Since we have seen hundreds of children with pectus carinatum, we do not need X-rays to diagnose it. This saves your child from being exposed to radiation.

Treating Pectus Carinatum

Treatment depends on which part of the chest wall bows out and how far. Some children do not need treatment at all. If they do, we almost always use a brace. Most children do not need surgery.

Braces for Pectus Carinatum

Our Orthotics and Prosthetics Department custom-fits a brace to reshape your child’s chest. Like braces on teeth, the chest brace puts gentle, constant pressure on the breastbone over many months. This pushes the breastbone into a normal position.
Your child may need the brace for up to 2 years, but many children are out of the brace much sooner. For the first few months, your child will wear the brace for most of the day. They can wear it at school, at the movies, while walking around the house and even sleeping at night. They will take it off for sports and bathing. The more your child wears it, the more likely it is to work. Once we see that it is working, they can wear the brace less.

Your child’s surgeon works with the Orthotics and Prosthetics team to check your child’s chest often and adjust their brace. You may see improvements within a few months. This approach has had success for many children over the years.

Surgery For Pectus Carinatum

We try to avoid surgery, but a small number of children we see do need an operation. Surgeons move the breastbone back into a normal position.

Before surgery
- Our surgeons will explain the operation and answer any questions you have.
- We will give your child medicine that makes them sleep so they don’t feel pain (general anesthesia).
During surgery
The surgeon:
- Will take out the sections of cartilage that make the breastbone push forward
- Rarely, may need to adjust the breastbone (sternum) so it will lie flat
Over time, the cartilage will regrow to support the breastbone in its new position.
After surgery
Your child will be in the hospital for 1 to 7 days. Before your child goes home, we will teach you how to:
- Give them pain medicine
- Care for their incision
- Limit your child’s activity while they recover
Your child will have a follow-up visit with the surgeon about 2 to 3 weeks after surgery. The doctor makes sure the incision is healing and that your child is healing well. Our providers and nurses are always here to answer your questions.