Chest deformities like pectus excavatum and pectus carinatum are quite common in teenagers. Particularly in an age of social media and body shaming, the physical appearance of both conditions can be very challenging for some adolescents.
LOC clinicians are very much aware of this as we have discussed the psychological impact with parents and directly with patients. Patients are unwilling to take their t-shirts off, go swimming or put themselves in any position where they might reveal their chests.
Not surprisingly both parents and teenagers are looking for an answer. Surgery on the NHS used to be an option but even before the pandemic that option had become increasingly unavailable since the condition was deemed to be largely cosmetic and no risk to physical health.
LOC has been offering a non-surgical solution to the problem since 2010. Our treatment combines bespoke chest braces with a very specific set of exercises.
Pectus Excavatum, also known as 'funnel' or 'sunken' chest, is where the breast bone is pushed abnormally inward.
Dr Haje was widely regarded as the world's leading authority on the non-surgical treatment of pectus deformities.
Pectus carinatum is also known as 'pigeon' chest and is where the breastbone is pushed outward.
There is no unified opinion on causation, but there is evidence to suggest that both pectus excavatum and pectus carinatum can be inherited conditions.
We are indebted to the late Dr Haje for the information that follows. Dr Haje was widely regarded as the world's leading authority on the non-surgical treatment of pectus deformities.
We have summarised his audit of the 4,346 patients he treated in the following page.
The London Orthotic Consultancy's treatment for pectus excavatum and pectus carinatum is non-surgical and involves wearing a bespoke brace or orthosis called a 'Dynamic Chest Compressor', combined with a programme of daily exercises. LOC has pioneered this method of treatment in the UK.
Although the optimum age for non-surgical treatment is during puberty, the key determining factor is the pliability of the chest wall so older patients can also benefit if there is a ‘give’ in their chest wall.
For further information about our non-surgical treatment programme and the use of orthoses, read about our non-surgical pectus treatment.
Most NHS trusts no longer recommend surgery for pectus carinatum and pectus carinatum as the conditions are considered to be cosmetic and no threat to physical health. Privately the type of surgery performed in the UK is either the Nuss or Ravitch procedures. The Nuss procedure is minimally invasive compared to the Ravitch.
Good results have been reported from both types of surgery and patients are generally pleased with the improvement in chest shape. However, these procedures do not address the problem of rib flaring, which is fairly common, and patients can be left with visible surgical scarring.
Read more about treatment for pectus deformities.
Daisy was X-rayed and diagnosed with mild scoliosis of nine degrees. They also confirmed that she had pectus carinatum but advised that, as they considered this a cosmetic issue, we should simply monitor it and take no further action” ... continue reading ...
Recently we had a 14-year-old pectus patient who attended The London Orthotic Consultancy for treatment for his pectus carinatum inferior with rib flaring after only being offered surgical solutions on the NHS ... continue reading ...
Jamie consulted his GP and was told about the option of surgery but was soon put off by the risk of scarring and lengthy recovery time. It was while on a beach holiday - and feeling particularly self-conscious ... continue reading ...
Currently, I am wearing my pectus brace for 12-14 hours a day and I am very happy with the results of my treatment. I am very grateful to all the amazing people at LOC and I want to thank them for helping me so much. In the year and a half since my treatment started, I have come so far and I am incredibly happy with the results and I am incredibly happy that I persevered.
You can get to a point, like where I am with Sam, where he says: ‘If you need the brace off for a few hours every now and again, you can'. I play football, so I can take it off for training and when I play on Saturdays. Six months in, I can see light at the end of the tunnel. It’s just a year, blast through it and you’re done.
The results are better than I thought, to be honest. When I set out to do it, I was hoping that you couldn’t see the pectus carinatum within my clothes, but I think I’ve got it to the stage where you wouldn’t even know without a top as well. So, it’s pretty much spot on. I think everyone’s noticed that I’ve got better posture, so I’ve felt more confident.
Victor the Robot, our new computer numerical control milling machine in action! Victor is noisy, but he’s transforming our ability to design and manufacture orthotic devices at our Kingston-upon-Thames clinic.
Manufactured by Rodin4D, Victor is capable of milling complex ergonomic shapes, meaning that we can now potentially assess a spinal orthotic patient, manufacture the orthosis and have it fitted, all in the space of a day. Victor can do everything we need to do for our patients, in-house and in the shortest time possible with no compromise on quality.
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