Pectus Carinatum

Pectus carinatum, or chicken breast, is caused by excessive growth of the rib cartilage next to the sternum. This excessive 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 triggered by medication, lung diseases or surgery on the chest. The defect may be located high or low on the chest and manifest symmetrically (both sides) or asymmetrically (one side). In 25-30%, a genetic factor plays a role and it occurs in several people in the family. It may occur in isolation, but in rare cases may also occur in combination with, for example, scoliosis, heart defects and a number of syndromes or connective tissue diseases (Marfan's disease).

One of the main reasons for treating a chicken breast is the cosmetic aspect and the possible psychosocial impact during puberty and development. There may be embarrassment about the abnormal chest and sometimes teasing from peers. A chicken breast rarely leads to physical complaints 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 find out more about your chest defect. For example:

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

Then 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 order additional tests, such as an ultrasound scan of the heart, a CT or an MRI scan. It may also be necessary to consult a cardiologist, orthopaedic surgeon or clinical geneticist.

A chicken breast can be treated in different ways:

An operation in which the cartilage next to your sternum that has grown too hard is removed and the sternum is moved backwards (Ravitch operation).
The pushing back of the sternum by means of a brace. As with dentist's braces, external pressure gradually pushes the chest back to its normal position over several months.

Both treatments are effective but not all chest wall deformities can 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.

Information letters

Chicken breast

h Information letter on chicken breast

h Information letter Abramson operation

h Brace information letter

h Information letter Ravitch Operation

Exercises

h Chest and back muscles general

h Chest and back muscles in surgery

Brace experience story

Slide the arrows sideways for the before/after photo

From high school onwards, I started noticing that my chest was different from others. Since water polo was my sport, I was shirtless a lot. I developed strange habits of trying to camouflage my chest abnormality. I was always busy with it, even though I had no physical abnormalities and I was not bullied. Still, at a certain point I went to see the doctor. He referred me to the hospital and by chance I ended up among the first people to get the brace.

I had one of the worst chest wall deformities of the whole group. So I went through a long process. In the beginning, it took a lot of getting used to, you get a limitation in your mobility, it hurts a bit and it can sometimes itch. But the progress I saw clearly gave me motivation. I wore it very faithfully. I wore it faithfully throughout the day and even on holiday, only to take it off when I was doing sports. An imprint of the brace could be seen on me and at first I got remarks too. Sometimes I got little wounds on my back, but I mainly got remarks about how well I was progressing.

"This gave me a lot more confidence, and the little inconveniences were 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 did not know about it. I did not think an operation to remove a protruding point was necessary. At school, only the teachers knew about it and I always did my best to hide it. But in hindsight, that would not have been necessary.

At some point I was allowed to cut it back and only wear it at night. I have always been afraid that it would come back and therefore did not dare to stop wearing the brace. But a few years later, my abnormalities have still not returned. This gave me a lot more confidence, and the minor inconveniences were well worth it to me.