Pectus excavatum surgery


Nowadays, pectus excavatum surgery is possible with a very advanced technique that creates a custom-made chest implant designed to fit the chest wall deformity perfectly. It is effective, less painful, and minimally invasive compared to other surgical options available. However, this surgery requires a plastic surgeon with wide experience.

We know that flaunting a perfectly ripped chest is the desire of many men. It can be seen as a sign of masculinity, much like beautiful breasts are for women. However, for many patients, body contouring chest surgery is a medical necessity. This is especially true for patients who suffer from pectus excavatum, also known as sunken chest deformity.

The psychological impact of an abnormal chest appearance is the most important symptom. It can cause distress, low self-esteem, and body image issues.

So, do you suffer from pectus excavatum? Keep reading because we have the right solution for you!

What Is Pectus Excavatum?

Pectus excavatum syndrome is a chest wall deformity that causes several ribs and the breastbone (sternum) to grow inward. This gives the chest a caved-in appearance.

Usually, the ribs and sternum project outward at the front of the chest. However, with pectus excavatum, the rib cage causes a sunken chest in the sternum area. That’s why this deformity is also called concave chest or funnel chest.

Sometimes, the lower ribs might flare out too. Also, the deformity may be symmetrical (present on both sides) or more prominent on one side of the chest. This congenital deformity seems to be linked to the cartilage in the ribcage overgrowing. It is more common in men and affects 1 in every 700 patients.

It doesn’t have a known cause, but it most probably is an inherited condition. Sometimes, it runs in families, with up to 25 percent of affected patients reporting chest wall abnormalities in other family members.

Pectus excavatum can be associated with other deformities such as scoliosis or Poland syndrome.

Patients with Noonan syndrome may have funnel chest as a symptom. Also, up to 70% of patients with Marfan syndrome are also affected.

Ultimately, pectus excavatum is not that rare. It is one of the most common malformations of the chest, representing nearly 90% of cases. The severity typically worsens during the adolescent growth spurt.


The main sign of pectus excavatum is a chest that looks sunken in. However, kids could be born with this deformity, but it might not be apparent in the first few years of life.

Many cases become more evident in the early teenage years. And even mild cases might be barely noticeable.

Pectus deformities go beyond causing aesthetic and psychological problems. Also, they can have consequences on pulmonary function. When the condition is severe, it compromises heart and lung function.

Indeed, severe pectus excavatum can put great pressure on the lungs and heart. It could even cause a physical displacement of the heart.

The most common symptoms are:

  • Limitation when engaging in physical activities.
  • Fatigue.
  • Shortness of breath. Since the ribcage is more rigid than normal, it can make it difficult to breathe out (expire) completely.
  • Pain, mainly in the chest and back area. It tends to worsen by exercise. It can be severe during periods of excessive growth.
  • Heart palpitations.
  • Frequent respiratory infections.
  • Coughing or wheezing.

The condition typically gets worse as the kids grow. Once the child is done growing, the symptoms should not get any better or worse.


The doctor will diagnose pectus excavatum based on a thorough physical exam and the kid’s medical history. If needed, he might also order exams, including breathing tests, to show the ribcage impact on breathing function. Also, scans are necessary to give detailed measurements of the ribcage.

Computed tomography, also known as a CT scan, can help measure the degree of compression on the heart and lungs. Also, cardiopulmonary exercise testing can assess how well the heart is working.

Many scales have been developed to determine the degree of deformity in the chest wall. They consider the distance between the sternum and the spine.

The Haller index is used based on CT scan measurements. This index is the ratio between the transverse diameter (horizontal distance of the inside of the ribcage) and the shortest distance between the vertebrae and sternum (anteroposterior diameter). A Haller index over 3.25 is often defined as severe and demands surgical correction.


Mild pectus excavatum generally doesn’t need treatment if the lungs or heart are not affected. However, when the condition causes health problems or the patients’ self-esteem suffers, it is time to consider surgery. In those cases, treatment can improve a child’s or adult’s physical well-being. Additionally, surgical correction can improve cardiovascular function to a certain degree.

Until a few years ago, pectus excavatum surgical repair had available two different procedures:

The NUSS procedure

A metal bar is placed inside the chest to lift the thorax. A stabilizer bar is added to keep it in place. The chest is permanently reshaped over three years. Eventually, both bars are surgically removed. The Nuss procedure is considered pediatric surgery. It is done in kids age eight and older.

The Ravitch procedure

The surgeon removes the abnormal costal cartilages and ribs and fractures the breast bone. Also, he places a support system in the chest to hold it in the proper position. This technique helps to surgically raise the sternum. The sternum and ribs heal in a flat, more normal position. This surgery is typically used for older patients between 14 to 21 years old.


Yes, a non-invasive option is physical therapy and exercises to strengthen the chest muscles. This helps to improve posture, increasing chest expansion, and enhancing exercise capacity.

In the case of mild pectus excavatum in young patients, parents can treat it at home with a vacuum bell device. This non-surgical approach uses a rubber device in the shape of a bell connected to a pump.

The bell device is placed on the chest two hours a day. The pump sucks the air out of the device, creating negative pressure (a vacuum) that pulls the chest forward. Overtime (1-2 years), the chest wall should stay forward on its own.

These non-invasive options rely on the chest wall elasticity, gradually stiffening with age. They have been developed to alleviate the condition progressively, especially in young cases.


As described above, traditional surgeries as the NUSS and the Ravitch procedures are invasive, painful, and could take years before seeing definite results. Also, they could cause significant complications such as cardiac perforation, pulmonary lesions, infections, or displacement of the bars.

On the other hand, non-surgical options may not always be effective and demand too much sacrifice or compromise from the patient.

Between these two options, there is a safe and definitive surgical method to correct pectus excavatum. With the support of the Anatomik Modeling Company, we can create a custom-made implant based on the thorax deformity using CT scan results.

The implant covers and adapts to the entire defect. It can be reshaped and adjusted in situ during the surgery, so the contours are hardly noticeable. Also, the implant can be combined with fat grafting to obtain more natural results.

This surgery is considered a benchmark procedure. It is simple, effective, and minimally invasive while offering excellent results. Also, it avoids open chest surgery and the complications that come with it!

Antiaging Group Barcelona is the only Spanish center of reference for Anatomik Modeling. Doctor Benito has received extensive training on the computerized construction of 3D implants and the intervention techniques. This plastic surgery should be carried out when body development has finished, though.


The advantages of Pectus Excavatum plastic surgery wit custom-made implants are:

  1. Customized and personalized surgery according to the existing deformity.
  2. Soft but medical silicon rubber material (different from the silicone gel used in breast implants), which feels like the sternum (chest bone).
  3. The implants are age-resistant and unbreakable.
  4. It is a permanent solution.
  5. The edges of the implant adapt to the defect and are also covered by the musculature.
  6. Minimally invasive repair.

The main disadvantage of custom-made implants is the cost, as they are very expensive. However, you should keep in mind that these are lifelong implants that don’t need replacing.

This procedure does not correct existing cardiac and respiratory problems. However, these cardiopulmonary effects are not life-threatening, and patients can live a normal life. In these patients, the psychological and emotional impact play a major role. So, the aesthetic results are the priority, as long it is not a severe case.


Pectus excavatum surgery using Anatomik Modeling implants lasts about 45 minutes.

This surgical procedure takes place in an operating room under general anesthesia. The surgeon makes a small incision of nearly 4-7 cm in the affected chest side to place the implant.

This technique can be carried out alone or combined with other treatments (breast implants, fat transfer, pectoral implants) according to the patient’s needs.

The hospitalization is shorter than with conventional surgery (Nuss, Ravitch). Physical exercise must be avoided for 8-12 weeks according to the size of the implant.

Yes, it is possible to improve the results obtained in a previous surgery. For patients who already had a repair surgery, one of the great advantages of the 3D implant is that the prototype is made using CT scan images. With these computer-aided designs, the defect is filled almost perfectly, so it doesn’t matter if the patient had corrective surgery before.

Each case is unique and special, though. Every patient needs a prior evaluation to decide if revision surgery is really worthwhile. For that reason, we recommend a first consultation with Doctor Benito to find the best option for you.


In women, pectus excavatum is five times less common than in men. It affects breast development and produces very significant breast asymmetry. The corrective surgery manages to increase both self-esteem and body image.

The simplest cases can be treated satisfactorily with a breast implant. Fat grafting also makes it possible to obtain better symmetry.

In 2015, the company’ Plastic and Reconstructive Surgery’ carried out a study on 47 women who had undergone funnel chest correction in the same hospital from January 2010 to September 2013.

This surgery was performed in patients with pectus deformity and an average age of 35 years. The results suggest that neither previous nor simultaneous breast augmentation increased the risk of complications. The authors recommended that cosmetic breast surgery be performed simultaneously as the correction of the pectus excavatum.

Pectus excavatum surgery in women


Surgery cost depends on the physical features of the patient and of the technique used. Without meeting the patient we don’t offer approximate prices as each patient is a different case. But we know that the economic factor is important when it comes to making a decision.

Therefore, we offer the possibility for the patient to come to Antiaging Group Barcelona facilities for a first, free, no-obligation visit.

You can consult with the surgeon regarding all your doubts and worries. Based on your characteristics, we will offer the best solution for your Pectus excavatum repair surgery.


There is a solution to Pectus excavatum, but it requires treatment and medical advice by a surgeon with wide experience in this field.

With more than 20 years of experience, Doctor Jesús Benito is known worlwide for his technique to correct the Pectus excavatum by using custom-made Anatomik Modeling implants.

Reconstructive surgery using custom-made implants is a personalised, safe and easy procedure which avoids open chest surgery and its possible complications.

Antiaging Group Barcelona is the only centre of reference in Spain for Anatomik Modeling.

Doctor Jesus Benito - Plastic Surgeon

Doctor Jesús Benito

Specialist in plastic and cosmetic surgery.
Worldly renowned in muscle implant surgeries for men.

  • Secretary of the ISAPS (International Society of Aesthetic Plastic Surgery).
  • Former president of the Spanish Association of Aesthetic Plastic Surgery (AECEP).
  • 2013 Gold Medal (Forum Europa)

More information about the medical team.

Bibliography & Publications:

Doctor Jesús Benito has published numerous articles in specialized journals which place him among the best specialists in Pectus Excavatum.

Do you want more information about pectus excavatum plastic surgery?

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    Dr Benito and Dr Salvador - Antiaging Group Barcelona

    Antiaging Group Barcelona

    Ronda del General Mitre, 84, 08021 (Barcelona, Spain)

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