Hey Gang,

Here’s the TL:DR—

54M got 3 bars with Dr J today. This post is about how I decided to get my pectus fixed at a later age than most (I had CHF symptoms that I believed were from sternal compression of my heart) and how I got my appointment with her. Most of it was written while I was waiting in preop. Here goes:

I’m having a 3 bar repair with Dr. J today!

I’m 54 and have always had poor exercise tolerance with any endurance activities. I knew about pectus from an early age (teens) and had seen a plastic surgeon in the 1980s who offered to put in a silicone implant. Nuss was very new and repairs were pretty radical surgeries in those days. 

 About 4 years ago I was feeling more dyspnea with exertion and wondered if I could have some coronary artery disease. (I had a couple of colleagues that had had heart attacks at an early age, so that’s what prompted that concern.) I asked my primary care doctor to order a stress test. 

I had a stress echocardiogram which was difficult for the cardiologist to interpret, likely because of poor windows (the echo probe needs to see all of the chambers and valves by peeking through the spaces between the ribs) which I attributed to my pectus. The big takeaway though, was that my inferior vena cava was severely dilated (>4cm). The IVC is the big blood vessel that returns venous blood to the heart to get moved into the lungs. 

Since my stress echo didn’t have good enough images to be diagnostic, I had a CT scan of my coronary arteries (CTCA), which showed normal coronary vessels, but my IVC was noted to be dilated. 

A severely dilated IVC is usually a sign of congestive heart failure, which I really didn’t think I had, so my PCP had me talk to a cardiologist. He also thought it was CHF and ordered a blood test  (BNP) which is a marker that can indicate CHF. My BNP was undetectable, and cardiology said that I don’t have CHF and nothing else was needed from a cardiology perspective. 

When I reviewed the images from my CTCA I could see the cardiac compression from my sternum. I put 2 and 2 together and realized that if my sternum is compressing my right ventricle (on the side of the heart where venous blood is pumped to the lungs) and my IVC is dilated, then my heart isn’t able to move through all of the blood that is returning to it. Physiologically it’s like CHF, only it manifests most when I’m exerting myself, like when I had the stress echo. 

I calculated a Haller index which was a significant number. A subsequent CT (for another thing I won’t waste time on) showed an HI of 4.1.

I started reading about pectus excavatum correction surgeries after this. I found out about Dr J from internet research and from a patient (I’m a physician) that I saw who had had a Nuss with Dr J in her 30s. She told me that Dr J had operated on patients in their 60s. This surprised and encouraged me. 

I tried to get an appointment with her, however this was not straightforward as she is no longer taking self-referrals for patients over 50. The office staff said that this was due to increased risk of coronary artery disease in that patient population. 

One of the perks of being a physician in a fairly big health system is that doctors tend to squeeze you in for appointments when you reach out to them personally. They still bill insurance and we still pay the copays etc, but often we can get pretty expeditious scheduling of appointments. 

I got an appointment in a week or two with one of the pediatric surgeons in our system who has done a lot of pectus surgeries, but typically only on teenagers and patients in their 20s. We talked for an hour and a half and because I was outside of his patient age range, he wrote me a referral to Dr J. He also sent her an email.  It also helped that she knew of him professionally, so I think his letter/email carried more weight than a letter from a physician that she wasn’t familiar with would be. 

Eventually (maybe after 2-3 weeks, I don’t recall) I got a call from Dr J’s office and got scheduled for a consultation. 

I saw her in January and was very impressed. She reviewed my testing with me and told me about risks and benefits. At my age there is a 10% chance of rib fractures. The bars need to stay in for 5 years to lessen the chance of regression. 

We planned on October for the operation. Commitments at home and work were why we scheduled so much later. 

We flew in to town on Sunday. Yesterday I had preop labs, a chest X-ray, and an EKG. I also had a preop visit with Dr J’s PA. 

This morning we arrived at 8:30 am. Met the anesthesia team, and Dr J’s assistant Jesse. Dr J answered all other questions.  Everyone was extremely professional and answered all questions thoroughly. Five stars. Would recommend. 

I’m pretty tired now and will add an update tomorrow.

Have a great night! Zzz

I'm no bodybuilder but just highlighting the improvements I think you can make by simply losing fat and gaining a bit of muscle. I am far more confident with my shirt off now. Posture makes a huge difference. I mainly worked on chest, shoulders and back whilst being in a calorie deficit.

You may not be able to tell so much from the picture but the difference in how noticeable my pectus is compared with day 1 is massive.

I plan on adding some size now and hoping it gets even less noticeable.

Hey everyone! I’m a 34 year old woman that has a modified ravitch procedure scheduled for 11/4/26. My surgeon told me that if I wanted, she could make incisions under each breast instead of midline in between my breasts if I didn’t want such noticeable scars. Has anyone that had the modified ravitch had their incisions under the breast vs midline? If so, do you regret it or are you happy with it?

Just curious on what people think of my Pectus severity. I have yet to see a doctor about it, and frankly I don’t know when I will. I have no family and live on my own so I don’t know how I’d handle recovering and I’d probably lose my job if I got surgery. I get “heavy” chest feelings randomly sometimes like if I eat a heavy dense meal. Workout and exercise intolerance does not seem to be the case for me. My cardiovascular health is terrible but I can probably knock out a mile or so before I’m dying. Workouts are fine, I don’t get lightheaded unless I’m hitting legs. I’m also probably in need of putting on mass. I’m 146 lbs and 6 ft.

Hey. I have no idea if this even is related to the surgery but I found absolutly nothing trying to google wtf is happening so let me know if you have heard of this or had this yourself. I'm currently 2.5 weeks post op and today when I woke up my skin has started to shed I quess😀. I have this weird shedding going on from my lower abdomen to my armpits and some on my back. I have never in my life had anything like this on my skin. Has this happened to anyone else and does anyone know if this is surgery related and what causes this. I know propably nothing dangerous but I'm interested to knowing what is happening to my body.

I'm in my late teens and was diagnosed with asymmetrical (left) pectus excavatum with a Haller Index of 4.07 and a correction index of 27.5%.

My thoratic surgeon (who discourages the nuss procedure even for severe cases in adults) recommended a standard Vacuum Bell (rouns) worn off-center for 2 hours a day on Day 1, to 18 hours a day by Day 48 for 18 months straight, which, seemed a bit extreme for what he described as a "mild" case.

Weeks into VBT, it started to feel like my cartilage by the sternum on my normal side started to lift together with the asymmetrical side, since the classical Vacuum Bell evenly lifts all areas covered, without distinguishing between normal and deeper parts.

I'm stressed out. I told my provider I felt like it was over-lifting normal ribs, which they mocked me for and dismissed as merely "feeling like," instead of ordering further tests or trying to explain stuff to me.

Another thing I noticed that most of their patients have symmetrical pectus excavatum and they seem to recommend a uniform timeline (2 — 18 hours per day for 18 months) to patients of all types and ages (upwards 25 year olds), which seemed a bit off? They didn't seem to like me asking questions either.

Have any doctors or patients faced similar cases?

I have now gone over 9 Months post surgery. The road and Journey have been a lot and still in pain daily when moving, Coughing, Sneezing etc. I would never change my experience other than maybe less brusing after surgery.

16yo son. CT report states HI of 5.5. Surgeon said 5.2. Neither gave a correction index. Surgeon's instructions were to take images at the holding of a neutral breath.

Son thought it'd be cool to do his own measurements. Not sure how close he got with his marks, but he got an HI 5.778 and CI 36.897%. Is he close? We're getting a 2nd opinion/option on Friday. Also, how much harder is this asymmetry to fix? Is an X pattern better when the deepest point is very low near xiphoid. Adding additional images for anyone who actually reads these. Thanks so much.

Sorry to be that person, but I recently discovered what pectus excavatum was and found it aligned with symptoms I have experienced all childhood.

I am currently a 21 year old healthy female, however, I have never been able to really exercise since adolescence due to easily being out of breath. I have gotten in a bit better shape now, but I have to plan out longer breaks.

I get lightheaded very easily and heart palpitations when I stand up. I have tried to correct my posture since I have always had "chicken wings" but then it feels like I am struggling to breathe or take a full breath.

I have passed out at work before after looking down preparing food for a while. Another instance I remember waking up feeling "weird" I knew that I felt like I was going to pass out, like that doom feeling. I ended up freaking out my mom by passing out in the middle of a restaurant. The closest thing I could describe it as was my heart felt off.

In the past 6 months, I have developed some major back pain and occasional chest pain. My bloodwork has come back fine, and when I mentioned my fainting episodes to my doctor (this was before I knew what PE was) he said that if it gets worse to come see him. I have a pectus specialist a couple hours away, but I don't want to schedule an appt if it could be a different underlying cause and not PE, but bras and swim suits have always been a bit off and left that gap in my sternum. The divot looks a bit worse IRL, but for modesty I gotta wear the swim top lol

Advice?

Hi everyone, new to the sub. Have a 1 month old baby and went in for our check up today. The ped noticed his PE, but said it looks mild and he could likely grow out of it (or it be a mild case). She checked his breathing and said everything else is fine.

Wife and I are a bit freaked out and we were looking at him closer. When he cries, the divot really raises and dips.

Is this normal? Does this look like PE to you? Mild/severe? It’s only this noticeable when he’s crying, breathing looks much more normal.

Please - any advice is much appreciated.

UPDATE: Thank you to everyone that commented, it is helped me so much. I just realized that his surgeon never even discussed asymmetry with us, how would we know if his chest asymmetrical or is that important?

I do Hello. My son is scheduled to have surgery on 11/03 and will be having two bars placed. I am really starting to get nervous for him and have second thoughts. I attached his results from the CT Scan. I am not asking for medical advice, just maybe someone's personal experience. He was recommended to do the surgery based on results and he has some complaints of breathless during excercise/running. He wants to get it done às well, because I believe it causes him a lot of insecurity. Do you have any regrets doing the surgery? If you had the chance at this age to do it, would you? If you did have it at this age, how was the recovery?

Hello. First of all, please excuse my English (I am using Google Translate). I am a 23-year-old woman living in Buenos Aires, Argentina. A couple of weeks ago, I had a CT scan, which showed a Haller index of 4.46; the report also mentions an "impression on the right ventricle."

The thoracic surgeon mentioned that, given my age and the fact that my sternum is exerting some pressure on my heart, it is highly likely that—should I decide to undergo surgery—the Ravitch procedure would be the approach used, though nothing has been confirmed yet.

I also wanted to mention that during the CT scan, I was asked to inhale deeply to fill my lungs. This made me wonder if my chest might appear more sunken (or perhaps the opposite?). Is it standard practice to be asked to inhale during a CT scan?

De nuevo, disculpen si hay algo mal traducido, gracias

I have seen my primary and surgeon about this last year and it’s apparently just muscle pain and inflammation. Just curious if anyone feels like this? Low key frustrating and wish I never gotten the surgery. I’m in more consistent pain but my sternum isn’t pushing on my heart.

Has anyone else had issues getting a Cardiac MRI? I’ve gone to two pectus surgeons, both said they’d stop treatment after a normal echo even though I have persistent symptoms and HI 3.3 with minimal right atrium compression noted on my CT. Thanks

A lovely place to hang out with fellas who have the same condition. You can talk on pectus related topics or have fun in off-topic channels.

17M, my pectus is moderate to mild, I just obtained a vacuum bell and I'll be posting progress pics under this post over the next few months. Best of luck to everyone else giving the vacuum bell a shot!

i’m on day five and today i just got to where i can stand up, adjust my chair, and slowly sit by myself. my 2 concerned this: i got flare busters or rib sutures whatever you call them and i am stuck hunched over right now. my second concern which might just be anxiety is running out of breath since it’s already low. has anyone had similar experiences and can let me know how it went for them? i’ll add my post op pic so you guys can kinda see. i dont really wanna force my self straight because i feel like it knocks the air out of me a lil.

but little summary
1. when will i be able to go straight and not tilted
2. when will the out of breath thing not even be a concern

When I had my CT scan, my Haller index was 2.0, but the assistant told me to just inhale and hold my breath. I filled my lungs quite a bit (she even said my lungs were huge, haha), and in the image results, I noticed that my chest was much larger than it normally is. Would it be good to measure it during exhalation? Would it change the result? Because my pectus is quite pronounced to be relatively "normal" according to the measured Haller index.

I've used this for 2 years now and have had good results with it. I'm only selling due to upgrading to the 21cm model to try and cover my lower chest more.

This is the 19cm standard size. Good condition, and pump still has lots of power in it. Looking for $250 USD. I can make an ebay listing for you to buy it through if interested.

Full VB details here

Sorry for the weird zoomed in video it was kind of hard to capture and actually see on video bcs I’m so pale lol it’s easier to see with the brightness down 🤡 😔 . This is directly under my sternum and at the top of my abdomen. I have moderate maybe severe??? PE and I often see my heart beating like this. Not doing anything intense, just stood up after laying down for a bit and I got a little lightheaded and blood started rushing. When you search for things like “is it normal to see your heartbeat” it’s mostly people like “Yeahhh I see my chest move up and down when it beats it’s totally normal! 🤪” but I can’t really tell if seeing the literal heart itself beating through the skin is something I am falsely attributing to PE or if this in fact does look like a symptom