I’m 25M with moderate PE and I have been using the vacuum bell about 1 hour per day fairly consistently (usually when studying) for the past month.

I’ve been seen by two different Thoracics Surgeons growing up who offered the Nuss and Ravitch if I was interested, but both were not particularly concerned.

I’m a resident doctor currently and my personal preference is to avoid surgery as much as possible if it is reasonable and safe. Having taken care of a lot of patients with post-surgical complications, it does tend to stick in your mind.

I have always thought about trying a vacuum bell as a conservative strategy, and one of my thoracics surgeon said it would be a good idea to try (but lack of research at my adult age). But all the ones i saw were super expensive.

I finally came across a vacuum bell on Amazon that was actually kinda affordable ($200).

And using it for a month, it has been incredible. I haven’t taken any objective measurements, but my family has definitely noticed lasting improvements. I also noticed my posture is significantly better when using the vacuum bell, which seems to help overall anyways. And the short term effect is really nice, if i want to go swimming or something, i’ll put it on an hour before (so the redness fades away) but my chest looks much improved for the next few hours.

Overall, it has really helped my confidence and improve my chest shape. And it is very easy to put on and incorporate with daily chores/exercise. I just wish I got it earlier in life. Even if it’s something i’ll need to consistently use long term, I personally don’t mind at all. Also the feeling of having your chest look and feel normal (even if short lived) is incredible.

TLDR: If you’re pretty certain you don’t want surgery at all. Consider a vacuum bell if you feel like, you would benefit!

Hi! I’m 5 years post op of having the nuss bars removed. I’ve been doing great! But, there’s a weird sensation I have in my sternum that I’m curious if anyone else in my similar situation has too?

It’s not painful in the slightest, but feels very uncomfortable. That’s the only way I can describe it. It doesn’t move or anything when I touch it, but it feels malleable… inside? I feel like, posture wise, I have to puff my chest out and sit straight up or it will start caving in. Lol, it obviously isn’t caving in, but that’s just what it physically feels like will happen? I don’t know if that part is psychosomatic, or what, but it’s just an odd sensation.

It’s not worrisome, like I don’t think I need to talk to my surgeon. But I am curious if anyone else knows what I’m talking about and/or if anyone has an explanation?

Wondering too if it’s just my nerves starting to fire back up and they’re just truly feeling differently? Because I’ve been numb since the surgery.

For those that have had surgical correction and have had significant physical improvement, can you share how your life has changed in a positive way? TIA 😊

Hello, when do you think I will be able to work out my chest after the surgery? I am 5 months post operation (NUSS).

To start off, I’ve been playing games online since I was 12 and i’m 21 now. Didn’t really think much of my posture or my pectus but now my pectus is pretty bad, I have crazy rib flare (i pulled it in for the picture), scoliosis, anterior pelvic tilt, and rounded shoulders to top it off. killer 5 combo. I want to bodybuild for aesthetics but pectus evactum, scoliosis, rib flare, anterior pelvic tilt, and rounded shoulders is killing my motivation for achieving an attractive body.

Are there any postural changes, stretches, or exercises that would benefit me a lot? Is it lack of abdominal strength? Bad posture? I really need help.

Hi everyone

I noticed on my paperwork that my correction index is 29%, but my haller index was 2.9, and it was measured on exhale. Is the correction index accurate regardless of how the CT scan was done?

Also if I were to get surgery, would surgeons focus more on the correction index or the haller index?

I am 25 and I’ve been struggling with symptoms, but doctors keep saying my condition isn’t severe enough. Is age going to make surgery harder or less effective?

Would appreciate any advice. Thanks

Wanted to share a recent case our team worked on involving a rare chest wall deformity that doesn’t get much attention. Some people might describe it as a mix of pectus excavatum (PE) and pectus carinatum, and while that’s not entirely wrong, it can be misleading when choosing the right treatment.

The patient was a 17-year-old male who came to us after struggling with this condition for years. He first noticed something unusual about his chest as a kid, but it wasn’t too severe at the time, so his family didn’t think much of it. Things changed when he hit puberty around age 12—his height shot up, and the deformity became more pronounced. He went to a local hospital, where they diagnosed him with a chest wall deformity, but no surgery was done. Over the years, the deformity gradually worsened. While it didn’t cause him any physical pain, the appearance of his chest started affecting his confidence.

On admission, we found that the middle of his chest wall at the sternal angle was protruding outward, extending towards the sides, with a depression in the middle beneath it. After a thorough pre-op workup, we confirmed the diagnosis of Wenlin chest, which has clear surgical indications.

The surgery was done under general anesthesia. We started with pre-shaping, followed by the Wenlin procedure and then the Wung procedure.

before surgery

after surgery

Wenlin chest is an extremely rare chest wall deformity, with fewer than 100 cases reported worldwide between 1952 and 2019(1.J Thorac Dis 2021;13(5):2968-2978. http://dx.doi.org/10.21037/jtd-20-3472). Because it’s so uncommon, researchers have given it a variety of names over the years, like Chondro-manubrial deformity, Currarino-Silverman syndrome, Pectus arcuatum, Pouter pigeon chest, and Type 2 pectus carinatum, among others. Despite all these names, there’s very little experience when it comes to treating it. This inconsistency in naming and understanding the condition has made it harder to study and even more difficult to treat effectively.

 Since our institution specializes in chest wall deformities, by early 2023, we had performed over 100 surgeries for this condition and developed a comprehensive surgical approach. With this experience, we felt it was time to standardize both the name and the treatment. That’s why we now refer to it as Wenlin chest and have worked on creating a standardized surgical method for it.

The most noticeable feature of Wenlin chest is the change in the sternum, especially at the sternal angle. This area thickens and sticks out, creating a shallow, angled deformity. Both the manubrium and body of the sternum also become unusually thick. Because of the severe protrusion at the sternal angle, the sternum takes on an“S”shape, which then affects the ribs and rib cartilage, causing the classic deformity with an upper protrusion and lower depression.

Typical appearance of Wenlin chest (Source: Chest Wall Surgery by Wenlin Wang, Jinan University Press, 2023)

Strictly speaking, Wenlin chest is a complex chest wall deformity that involves both protrusion and depression. If you think of it as just a“stacking”of PE and pectus carinatum, some might opt for an easier solution, like the sandwich procedure. However, this approach is risky and likely won’t work. And we’ve seen two serious cases where doctors attempted to use the Nuss procedure, which led to surgery failure and actually made the problem worse.

Attempting the Nuss procedure for Wenlin chest, treating it as pectus excavatum, which led to surgical failure.

Attempting the Nuss procedure for Wenlin chest, treating it as pectus excavatum, which led to surgical failure.

What makes Wenlin chest so unique is its pathology, particularly the changes at the sternal angle. This area bears a lot of stress, and if you don’t address this stress in surgery, the procedure can’t be done properly. We realized this early on and tried various approaches. We started with open surgery, then tried semi-open surgery, and eventually figured out a minimally invasive approach that solved the stress issue. Now, minimally invasive surgery is the go-to method for correcting this deformity, and we’ve been able to achieve successful outcomes.

Hi, I am 33yf 1 month after nuss procedure. During the day pain is manageable but during the night is quite horrible.

I just wanted to share that my life savers during the recovery was travel pillow and big noise canceling headphones. Also I was living in button shirts first three weeks after surgery.

Also do u have any suggestions about pain management during the night?

My brother can speak calmly while running fast, I run at almost the same speed, but I can't speak because I don't have enough air, do you have these cracks behind your ribs?

I’m 35 and have been having regular black outs when standing up from seated positions. This has occurred occasionally throughout my life but over the last 2 years it’s become increasingly more frequent.

After a couple of bad blackouts last year I ended up in ED and referred to a Cardiologist. Some minor abnormalities were identified but nothing to pinpoint the cause of the blackouts.

Specialists/Physio’s etc. seem to gloss over the fact that I have PE. Often I hear the same thing along these lines - ‘have you had any problems with it up until this point, no? Then it’s likely only an aesthetic issue.’ I’ve therefore believed it’s some unknown issue that’s unrelated to PE.

After worrying about these more recent frequent blackouts, I’ve stumbled across some literature that links PE with postural hypotension. Quite easy to find on Google. It seems stupid that it never clicked to me before but it’s been a bit of a lightbulb moment. I’m going to flag it with my Cardiologist at my next appointment in a couple of weeks.

Curious if anyone else experiences these symptoms, and if so, has a clinician ever made the connection to your PE, and have you had any success with treatment as a result?

UPDATE: after raising it my GP (and him Googling the articles) he believes the PE would be the cause of my symptoms and has referred me to a Cardiothoracic surgeon for review. Appointment is in two weeks along with a follow up with the Cardiologist - hopefully on the right path now.

I have, and I think a lot, I deprive myself of a lot of things, I don't feel like living anymore.

Hi!

I got my 2 Nuss bars out yesterday after 5.5 years. Surgery went well and I was discharged immediately afterwords.

I’m definitely sore, but I am anxious because my doctor shared that the pain will only get worse over the next couple of days. Is that true? If so, when will I start to feel better and not worse?

Thank you!

I went to the hospital today for a CPET (Cardiopulmonary Exercise Test) because my doctor ordered it to evaluate my pectus excavatum. During the test, the pulmonologist mentioned that while I was exercising, my airways closed up like I have asthma.

Now I’m wondering: could the “negative” results from the CPET be more about asthma and not my pectus excavatum? Does anyone here have both asthma and pectus excavatum? How can they discern between the two when it comes to exercise-related breathing issues?

My whole life I thought I had just good chest genetics. Which I may still do.

Over the last year I have been experiencing some blood pressure issues.. systolic is 130s-140s.. and my diastolic stays lower around 55-65. Havnt seen 70s in over a few years.

I workout and cardio 6 days a week.

My cardio told me I have some endothelial dysfunction.

Recently was told I have Lyme disease. This doc was the one who brought up my chest being pushed in.

Does this have any impact on my heart? Blood pressure etc? I don’t have any chest pain.

What testing should I look into doing? How do I bring this up to my cardiologist?

Is surgery necessary? What types of surgeries are available?

Any tips would be appreciative as this is all VERY new to me.

I posted on here a while back about a radiologist referring me to a cardiologist for my PE and pressure on my right atrium, IVC, and mediastinum. So, I see the cardiologist, report my symptoms, reason for visit/referral, talk about my PE, etc. We did an EKG that day, and he ordered the Echo. I havent had one in a long time (it hurt and I took a while longer that it should have), but the echo technician noted my Mitral Valve Prolapse, Mitral Regurgitation, and Mumur, but couldnt dx anything, of course. Well, fast forward to a week ago and this is what’s going on, plus 3 new meds.

Does anyone else on here have any other heart abnormalities, diseases, defects, etc.? Is it PE-related? How do you know? How do others on here deal with news related to the thoracic-cardiac stuff thats not ideal?

23F and just learned what Pectus Excavatum was—I’m almost certain I have it as my chest is “caved in” and I have issues with heart palpitations, exercise intolerance, low stamina. I want to make an appointment with my primary care physician to get a referral to a specialist, but I don’t really know how to go about that. I feel weird just calling the doctor and saying “I think I have this thing”, but I don’t know how else to do it—any advice? Am I just being too self-conscious?

Exploring options in the UK

• where is best?
• I'm 28 in 6 months, am I too old?
• any serious risk with the operation?

Some time ago, I was offered two means of sorting out my pectus. I could have a corset that would act on the other side of my ribcage to even the two sides out, the cheaper option, or I could have a relatively expensive surgery that I would have to pay for, since the pectus doesn’t affect my health and that I live in Canada. My mother seems dead set on the corset, which I loath with a burning passion. Should I get treatment, and if yes, should I fight to get the surgery?