Pectus Excavatum

What is Pectus Excavatum? | Pain Management | Activity/School | Care of Incision | Medic Alert Bracelet

What is Pectus Excavatum?

Pectus Excavatum describes an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance.

Pectus excavatum is a congenital (present at birth) abnormality that can be mild or severe. It usually develops during pregnancy. It is caused by too much growth of the connective tissue that joins the ribs to the breastbone. This causes the sternum to malform inward. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep.

If pectus excavatum is severe, it may affect the heart and lungs, making exercise difficult. Also, the appearance of the chest may cause psychological difficulty for the child.

Pain Management

Your child will be given several medications to help control his/her pain. Some medications are taken 'as needed'. Others are given at specific times. Take all medication as directed.

Most patients say that the pain is worse at night and also first thing in the morning.

It is more comfortable to sleep in a semi-upright position, like in a recliner. This may provide better rest for 3-4 weeks.


  • No rigorous physical activity for 4 weeks after surgery.

  • Walking is excellent exercise and should be encouraged.

  • Encourage good posture. NO slouching!

  • No heavy lifting (>5 lbs) for 3 months after surgery. This includes backpacks for school.

  • No contact sports or gymnastics for 3 months after surgery.

  • Return to school 2-3 weeks after surgery or sooner if your child is ready.

Due to federal government laws regarding privacy (HIPPA), we cannot release information regarding your child's health without your permission. Please obtain written notes for school/work prior to leaving the hospital.

Care of Incisions

  • Shower five days after surgery

  • Swimming is permitted 2 weeks after surgery

  • Steristrips are covering the small incisions. Leave them in place for 1 week. If they are still intact after 2 weeks, remove them.

Medic Alert Bracelet

Your child should obtain a Medic Alert Bracelet. 

  • The inscription should read: "Surgical steel bar in place under sternum." 
  • On the accompanying card should be written: "CPR can be performed. May require more external force. If defibrillation is needed, paddle placement needs to be anterior/posterior."
  • The bracelet will also assist at security check areas.

Call the Pediatric Surgery office 410-328-5730:

If you have questions or concerns regarding your child's recovery, please call the nurse practitioners between 8am and 4pm daily. After hours and on weekends, call the surgeon on call 410-328-5730 if you have an emergency.

Reasons to call:

  • Temperature greater than 101°
  • Redness, drainage or extreme swelling at the incisions
  • Significant bleeding from the incisions
  • Worsening chest pain, especially with deep breaths
  • Pain, not controlled by the medicine
  • Difficulty breathing
  • Continual cough
  • Injury to the chest