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Pectus Carinatum

Pectus carinatum, or chicken breast, results from too hard growth of the rib cartilage next to the sternum. This too hard growth pushes the sternum forward. This growth occurs mainly during the growth spurt, and it is during this period that we often see progression of the chicken breast. The exact cause of this overgrowth is unknown but sometimes it is initiated by medication, lung disease or surgery on the breast. The defect may be located high or low on the chest and manifest symmetrically (both sides) or asymmetrically (on one side). In 25-30%, a genetic factor plays a role and it occurs in several people in the family. It can occur in isolation but in rare cases can also occur in combination with, for example, scoliosis, heart defects and some syndromes or connective tissue diseases (Marfan's disease).

One of the main reasons to treat a chicken breast is the cosmetic aspect and the possible psychosocial impact during puberty and development. There may be embarrassment over the abnormal chest and sometimes bullying by peers. A chicken breast rarely leads to physical symptoms but there may be:

  • pain
  • shortness of breath
  • fatigue
  • reduced stamina

When you visit a doctor, he or she will first ask you some questions to clarify more about your chest abnormality. For example:

  • What kind of complaints do you have?
  • Do you ever get bullied?
  • Does the abnormality run in the family?

Next, the doctor will want to look at and examine your chest. Depending on the shape of your chest, your build and based on information about chest abnormalities or other conditions in your family, the doctor may decide to have additional tests such as an ultrasound of the heart, a CT or MRI scan. It may also sometimes be necessary to consult the cardiologist, orthopedic surgeon or a clinical geneticist.

A chicken breast can be treated in several ways:

  1. An operation in which the cartilage that has grown too hard next to your breastbone is removed and the sternum is moved back (Ravitch surgery).
  2. Pushing the breastbone back using a brace. In this process, like a brace from the dentist, pressure from the outside pushes the chest back to its normal position gradually over several months.

Both treatments are effective but not all breast deformities allow themselves to be corrected with a brace. Which treatment you qualify for depends on a number of factors, such as the severity and stiffness of your chicken breast. After his examination, the doctor will discuss with you which treatment is best for you.

Experience story Brace

Slide the arrows sideways for the before/after picture

Slide the arrows sideways for the before/after picture

Starting in high school, I began to notice that my chest was different from others. Since water polo was my sport, I stood shirtless a lot. I got weird habits of trying to camouflage my chest abnormality. I was always working on it a lot myself, even though I had no physical abnormalities and was not bullied. Still, at some point I went to the doctor. The latter referred me to the hospital and I ended up by chance among the first people to receive the brace.

I had 1 of the worst abnormalities of the whole group. So I went into a long process. In the beginning it took a lot of getting used to, you get a restriction in your mobility, it hurts a little bit in the beginning of the adjustment and it can sometimes itch. But the progress I clearly saw gave me motivation. So I wore it very faithfully. All day long and even on vacation, only at my sport I took it off. I had an imprint of the brace on my back and at first I also got remarks about it. Sometimes I got little wounds on my back, but I mainly got comments about how well I was progressing.

"This provided a lot more confidence, and the minor inconveniences were well worth it for me."

With more strength training and having worn the brace for a year, my defect was no longer visible to those who knew nothing about it. An operation to remove a protruding tip was not necessary. At school only the teachers knew about it and always did everything they could to hide it. But in retrospect that would not have been necessary.

At one point I was allowed to taper off and wear it only at night. I was always afraid that it would come back and therefore did not dare to stop wearing the brace. But several years later, my deviations still haven't come back. This made me feel much more confident, and the minor inconveniences were well worth it for me.