Pectus Excavatum Treatment in Turkey: Cost, Surgery Options and Recovery

What is a pectus excavatum?

Funnel chest or pectus excavatum is a deformity of the chest wall in which the sternum and the lower costal cartilages sink inwards, giving the chest a hollow or bowl shape. It is the most common chest wall deformity and affects boys more often than girls. It can be treated, with or without surgery depending on its severity.

Indications for funnel chest surgery

The deformity often becomes more marked during the adolescent growth spurt. In some patients it causes symptoms such as:

• Chest pain
• Shortness of breath on exertion
• Palpitations
• Back pain or poor posture
• Reduced stamina during exercise

Many patients have no physical symptoms, but the appearance of the chest can affect self-esteem.

Treatment depends on the severity of the deformity, measured on a CT scan (Haller index),and on its effects on the heart and lungs. Mild forms may only need monitoring or a vacuum bell. Surgery is considered for moderate to severe forms, or when the deformity causes symptoms or significant distress.

Diagnosis of pectus excavatum

The assessment of pectus excavatum includes several tests requested by the surgeon to measure the deformity and check its effects on the heart and lungs.

Chest X-ray

A chest X-ray shows the depression of the sternum and gives a first idea of its severity.

CT scan or MRI of the chest

A CT scan gives cross-sectional images of the chest. It is used to calculate the Haller index, which measures the severity of the deformity, and to see how much the heart is compressed or displaced. A chest MRI can provide similar information without radiation.

Echocardiography

Echocardiography (heart ultrasound) checks heart function and the heart valves, and looks for compression of the heart by the sternum.

Lung function tests

Lung function tests (spirometry, sometimes an exercise test) measure lung volumes and airflow and assess the impact of the deformity on breathing.

Pectus Excavatum Treatment Options

Treatment options depend on the severity of the deformity, its effects on the heart and lungs, and your goals. They range from non-surgical methods to chest wall surgery.

Surgical techniques: correcting the chest wall

For patients with physical symptoms or a moderate to severe deformity, surgery is the reference treatment. The Nuss procedure is the most widely used minimally invasive technique: one or more curved metal bars are inserted beneath the sternum through small side incisions to push it outward, without removing cartilage. The bar is removed after 2 to 3 years. Sternochondroplasty (modified Ravitch technique) is an open operation in which the surgeon removes or reshapes the deformed costal cartilages and repositions the sternum. It is often used for complex or very asymmetrical cases.

Aesthetic options: correcting the appearance

These options improve the appearance of the chest but do not correct the position of the sternum or relieve heart or lung compression. 3D custom-made implants, designed from the patient's CT scan, are silicone implants placed under the skin and muscle to fill the depression; they require surgery. Lipofilling (fat grafting) uses the patient's own fat for mild cases or to refine contours; part of the fat may be reabsorbed and several sessions may be needed.

Non-surgical option: the vacuum bell

The vacuum bell applies suction to the chest wall for several hours a day over months or years. It can gradually lift the sternum, mainly in children and adolescents with a flexible chest and a mild to moderate deformity, provided it is used regularly.

Recovery After Pectus Excavatum Surgery

Recovery after pectus excavatum surgery happens in stages. The timeline varies with the technique and your general health; the stages below are indicative and apply mainly to the Nuss procedure.

What recovery looks like

The first days are the most painful. You will usually spend 3 to 5 days in hospital, where the team controls your pain and monitors your breathing.

By the second week, most patients move around at home and resume light daily activities. The chest remains tender for several weeks.

Between one and three months, discomfort decreases and the body adapts to the bar. Posture and exercise tolerance may improve, to a degree that varies between patients.

From three to six months, with your surgeon's agreement, you can gradually return to sport and full physical activity.

For Nuss procedure patients

The metal bar remains in place for 2 to 3 years to hold the chest wall in its corrected position while the cartilage stabilises. It is then removed during a second, shorter operation, which also carries risks (bleeding, infection, pain).

Your role in recovery

Respecting activity restrictions, attending follow-up appointments and reporting any unusual symptoms early (increasing pain, fever, shortness of breath) are essential. Avoid contact sports and heavy lifting until your surgeon allows them, as they can displace the bar.

Send us your medical reports to have your situation reviewed by a thoracic surgeon at a partner clinic.

Who is a good candidate for pectus excavatum treatment?

Pectus excavatum treatment is considered for patients whose chest deformity causes physical symptoms or significant distress. Good candidates generally include:

• Adolescents or adults with a moderate to severe chest depression confirmed by imaging.
• Patients with functional issues, such as shortness of breath or reduced endurance during exercise, or signs of heart compression.
• Patients whose chest appearance strongly affects their self-esteem, after a realistic discussion of expected results.
• Patients in good general health, able to follow the recovery period and, after a Nuss procedure, a second operation to remove the bar.

If concern about appearance is excessive and out of proportion to the deformity, a psychological assessment is recommended before any surgery.