Pectus excavatum vs pectus carinatum: what’s the difference?

Pectus excavatum: a sunken chest

Often described as a “sunken chest” or “funnel chest,” pectus excavatum occurs when the breastbone is pressed inward, creating a noticeable dip in the centre of the chest. This condition typically becomes more pronounced during periods of rapid growth, such as puberty. In more severe cases, it can affect posture, breathing, and even heart function.

At LOC, we use a non-surgical method known as a vacuum bell alongside as the dynamic chest compressor to gradually reshape the chest wall. This treatment is typically combined with a tailored physiotherapy programme to improve posture and muscular strength, enhancing both cosmetic and functional outcomes.

You can read Charlie’s story here

Pectus carinatum: a protruding chest

Also known as “pigeon chest,” pectus carinatum is the opposite of pectus excavatum; in this case, the breastbone protrudes outward. This condition can also become more noticeable during growth spurts. While it rarely affects internal organs, it may cause discomfort, self-consciousness, or issues with body image.

For pectus carinatum, LOC offers a bespoke chest orthosis designed to apply gentle, consistent pressure to the chest over time. Like with pectus excavatum, physiotherapy is an important part of the treatment process.

Discover Ethan’s journey and treatment experience here

Understanding the difference

Pectus deformities are conditions affecting the shape of the chest wall, and they most commonly occur during periods of rapid growth, such as adolescence.

The key difference lies in the direction of the chest wall deformity:
pectus excavatum = chest sinks inward
pectus carinatum = chest protrudes outward

Pectus excavatum is the more common of the two, affecting approximately 1 in every 300 to 400 children, and is seen more frequently in boys. Pectus carinatum is less common, with an estimated prevalence of about 1 in 1,500 children.

What are the symptoms associated with these conditions?

Symptoms can vary depending on the severity of the deformity:

• pectus excavatum: In mild cases, individuals may experience no symptoms other than cosmetic concerns. In more severe cases, the sunken chest can compress the heart and lungs, leading to shortness of breath, chest pain, fatigue, and reduced exercise tolerance.
• pectus carinatum: This condition is often asymptomatic but can cause chest pain, tenderness, and psychological distress due to the protruding chest appearance.

What can be done to correct these conditions?

At LOC, we offer non-surgical orthotic treatments tailored to each individual’s needs:

• pectus excavatum: Treatment may include the use of a vacuum bell device, which creates negative pressure to gradually elevate the sunken sternum. Physical therapy and exercises to improve posture and strengthen chest muscles are also recommended.
• pectus carinatum: A custom-fitted chest brace applies gentle, consistent pressure to the protruding area, gradually reshaping the chest wall over time. The success of this treatment depends on the flexibility of the chest wall and adherence to the bracing regimen.

For detailed information on our treatment options, please refer to our pectus excavatum and pectus carinatum pages.