Pectus Excavatum: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Pectus Excavatum?
A pediatric surgeon (a surgeon for children) or a thoracic surgeon (a chest surgeon) usually repairs pectus excavatum when treatment is needed. A primary care doctor or a pediatrician (a children's doctor) can do the first exam and talk through your options. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is pectus excavatum?
Pectus excavatum is a condition where the rib cage forms in a way that gives the chest a caved-in or sunken look. It is also called funnel chest, cobbler's chest, or sunken chest.
It is the most common chest wall deformity, which means an unusual shape of the chest wall. The dip involves the breastbone, called the sternum, and the cartilage (the bendy tissue) of the lower ribs. The condition can be mild or severe.
Symptoms
The main sign is a dip in the chest over the breastbone. The dip may look quite deep.
Other signs can include:
- Chest pain.
- Trouble breathing.
- Feeling tired, even when not being active.
- Feelings of depression or anger about the condition.
If the condition is severe, the heart and lungs can be affected. The way the chest looks may also cause emotional stress for a child.
The dip is present at birth in many cases. It is more often noticed after age 10. In most cases, the chest wall changes quickly during the growth spurt before puberty. After age 16, when skeletal growth has nearly or completely stopped, the change stops as well.
Causes and who gets it
The exact cause is unknown. Pectus excavatum may occur by itself, or there may be a family history of the condition. It starts while a baby is developing in the womb, and it can also develop after birth. Too much growth of the connective tissue that joins the ribs to the breastbone makes the breastbone grow inward.
Other health problems are linked with this condition, including:
- Marfan syndrome, a connective tissue disease.
- Noonan syndrome, a disorder that causes many parts of the body to develop abnormally.
- Poland syndrome, a disorder that causes muscles to not develop fully or at all.
- Rickets, a softening and weakening of the bones.
- Scoliosis, an abnormal curve of the spine.
How doctors diagnose it
A provider does a physical exam and asks about medical history. Questions may include when the problem was first noticed and whether other family members have an unusual-shaped chest.
Tests may include X-rays and a CT scan of the chest. Tests may also be done to find out how severely the lungs and heart are affected. Other tests may be done to rule out suspected disorders.
Treatment
This condition can be surgically repaired. Surgery is generally advised if there are other health problems, such as trouble breathing. Surgery may also be done to improve the appearance of the chest. Surgery remains the main treatment.
The main repair done around the world today is the minimally invasive repair, a technique reported by the surgeon Donald Nuss. The surgeon uses small cuts and does not remove any cartilage. A curved steel bar is placed under the breastbone to push the chest into a better shape. Talk to your provider about treatment options.
When to see a doctor
Contact your health care provider if you or your child feels tired even when not active. Also reach out if you or your child has feelings of depression or anger about the condition.
Call 911 or go to the emergency room if you or your child faints, has trouble breathing, or has chest pain or discomfort lasting two minutes or more.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can do a first exam, talk through symptoms like tiredness or trouble breathing, and refer you to a surgeon when treatment is needed. They can also help with follow-up after care.
Common questions
Is pectus excavatum dangerous?
It can be, but not always, because the condition can be mild or severe. If it is severe, the heart and lungs can be affected.
Does pectus excavatum run in families?
Sometimes it does, because there may be a family history of the condition. The exact cause is still unknown.
Does pectus excavatum get worse over time?
Yes, it often does during the growth spurt before puberty. After age 16, when growth has nearly or completely stopped, the change stops as well.
When is surgery advised for pectus excavatum?
Surgery is generally advised if there are other health problems, such as trouble breathing. It may also be done to improve the appearance of the chest.
Sources
- MedlinePlus - Pectus excavatum
- National Library of Medicine (PubMed Central) - Current Concepts in the Etiology and Pathogenesis of Pectus Excavatum in Humans
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
