Do I have pectus excavatum? Key signs to look for and how to tell

Pectus excavatum in adults, children and women: causes, severity and when to seek advice

Pectus excavatum, sometimes called a “sunken chest”, is a condition where the breastbone is pressed inward, creating a dip in the chest wall. It’s the most common chest wall difference and usually becomes more noticeable during periods of rapid growth, like puberty.

For some people, it’s purely cosmetic. For others, it can affect breathing, posture, or self-esteem. If you think you or your child might have pectus excavatum, here are the key signs to look out for and when to seek advice.

1.  A visible dip or hollow in the chest

The most recognisable feature of pectus excavatum is a noticeable dip or hollow in the centre of the chest. It might be:

• shallow and subtle
• deeper and more pronounced
• paired with flared ribs, where the lower ribs stick out

You might only notice the shape when looking in the mirror, getting changed, or doing sports. For many, it becomes more obvious during teenage years as the body grows.

 2.  Breathlessness during exercise

In moderate to severe cases, pectus excavatum can restrict chest expansion. This may lead to:

• feeling short of breath during physical activity
• reduced stamina or slower recovery after exercise
• chest tightness or discomfort

Not everyone experiences these symptoms, but if your breathing feels different from that of your peers or has changed over time, it’s worth getting checked.

3. Poor posture and muscular imbalance

Many people with pectus excavatum unconsciously adjust their posture to compensate for the chest shape. You might notice:

• rounded shoulders or slouching
• tightness across the chest or upper back
• neck and shoulder strain, especially after long periods of sitting or standing

These changes can sometimes make the chest dip look more prominent, especially when combined with growth spurts.

4. Feeling self-conscious or anxious about your chest

It’s very common for people with pectus excavatum to feel uncomfortable with how their chest looks, particularly teenagers and young adults. You might:

• avoid fitted clothing or going shirtless
• feel anxious in changing rooms or at the beach
• experience low confidence or body image concerns

At LOC, we understand that emotional well-being is just as important as physical health. We always take a supportive, person-centred approach to treatment.

5. Family history

Pectus excavatum can run in families. If a parent, sibling, or close relative has a similar chest shape, there’s a higher chance of others in the family developing it too.

If you’re not sure whether a dip in the chest is normal or inherited, a clinical assessment can help you understand what’s going on and whether any treatment is needed.

How do we assess pectus excavatum at LOC?

If you recognise any of these signs, our experienced clinicians can assess your chest shape and advise on the best options. Our approach includes:

• a thorough clinical examination
• 3D chest scanning to monitor shape and progress
• a review of posture, breathing, and flexibility
• a tailored treatment plan based on your age, goals, and severity

You can book a free virtual consultation to start with, there’s no commitment, and it’s a chance to ask questions and explore next steps.

Improve your chest shape with our slimline pectus brace

Non-surgical treatment options at LOC

We’re one of the UK’s leading clinics offering non-surgical treatment for pectus excavatum. Our approach combines:

Vacuum bell therapy

A clinically proven device that uses gentle suction to help lift the breastbone over time. Best results are seen in younger, more flexible chest walls, but adults can benefit too.

Pectus-specific exercises

A physiotherapy-based programme to strengthen chest muscles, improve posture, and support shape change. We tailor exercises to suit your age and ability.

Rib flaring support (if needed)

If there’s visible rib flaring alongside the dip, we may recommend a soft rib brace to guide the lower ribs into a more natural position.
We work closely with you throughout treatment, with regular check-ins, imaging, and support to help you get the best possible outcome.

When might surgery be needed

In some cases, particularly when the sunken chest affects heart or lung function, surgery such as the Nuss procedure may be considered. At LOC, we’ll refer you to a specialist team if we feel that surgery is a better option than bracing or physiotherapy.
But for the majority of people we see, non-surgical treatment is effective and well-tolerated.

Should I seek help?

If you’ve noticed any of the following, it’s worth getting in touch:

• a visible dip or hollow in your chest
• breathlessness during activity
• poor posture or muscle tightness
• concerns about appearance or self-confidence
• a family history of pectus conditions

We’re here to help you understand what’s going on and to guide you through your options.

Get started

If you think you or your child may have pectus excavatum, you don’t need to wait. Book a free virtual assessment with one of our specialised orthotists. We’ll take the time to understand your concerns and explain the most appropriate next steps.

You can also read more about pectus excavatum treatment here.