What is pectus carinatum?
Pectus carinatum is a malformation of the chest characterized by a protrusion of the sternum (breastbone) and ribs. While surgery or bracing are not required, people with pectus carinatum might feel self-conscious, uncomfortable, or distressed by their appearance.
Pectus carinatum affects about 1 in 1,000 children. It’s more common in boys than girls, and even though it is present at birth, it’s often first noticed during puberty.
While most people will not have symptoms, some individuals may experience pain or discomfort associated with certain activities and positions. In some cases, it can lead to bad posture and back pain. Bracing is a nonoperative intervention used to correct pectus carinatum that is generally more effective in children and teens.
Studies report that most patients are satisfied with their post-bracing appearance, experienced minimal discomfort while bracing, and would use the brace again.
When a patient first notices their pectus carinatum, the first healthcare professional they will see is their primary care doctor. Then they will see a specialist in the pediatric surgery department to discuss treatment options. If bracing is recommended, the patient will then be referred to an orthotist. An orthotist is a healthcare professional who designs and fits braces to support and protect a patient’s musculoskeletal system.
Why Choose Us?
At the Orthotics and Prosthetics Center at University of Michigan Health, we design a custom-made brace to treat pectus carinatum. Based on a patient’s anatomy, a rigid brace with gel pads applies pressure at the front and back of the chest’s peak protrusion. The straps on the brace help keep it in place and maintain consistent pressure throughout the day.
At our initial appointment we will take measurements of the chest protrusion and a 3D scan of the patient’s torso. This allows us to design the pectus orthosis. At the next appointment, we fit the brace and make any necessary adjustments. After that, the patient begins their treatment, with the support of their family and their orthotist.
The doctors, surgeons, orthotists, families, and most importantly, the patient, all are a part of the team that treats pectus carinatum. The team at the Orthotics and Prosthetics Center will stay in regular contact with each of the patient’s care team members, working to ensure treatment success.
Bracing Tips
- Know your options. Bracing is just one option for treating pectus carinatum. Surgery is another, and it’s worth talking to a surgeon about what that process might look like. When all options are clear to you, you can feel more confident in your choice.
- Why Bracing? If you do choose bracing, take a moment to think about why. What’s encouraging you from within to give bracing a try? Write it down. It’s always good to have a reminder later on.
- Understand wear times. Wearing a pectus brace isn’t easy. We recommend wearing your brace 20 hours a day for the first several months. While successful outcomes can’t be guaranteed, you can put yourself in the best position to succeed by wearing your brace as much as possible.
- Set Goals. 20 hours a day may seem like a mountain. But our patients climb it one step at a time. Set goals on how many hours you will wear the brace and ask family members to hold you accountable. Maybe you get to go out to eat or watch a movie if you reach your goals. Make it unique to you. Be sure to update your goals as you progress and wearing your brace will get easier with each step.
- Keep at it. There will be days when wearing your brace feels impossible. That’s normal. You can absolutely take a break on those tough days, but don’t forget what led you to choose bracing. The best chance for success is by wearing the brace as much as you can.
- Talk to your friends about it. Oftentimes, we worry about what others will think. You might choose to explain to your friends why you’re wearing a brace and find it easier to wear it around them afterwards. Other times, people might not understand the brace even after you’ve explained it to them. That’s OK too. Wearing a pectus brace is something you’re doing for you, and not anyone else. All that matters is you.
- Find what fits. We want you to wear the brace as much as possible, so find ways to make it comfortable for you. You can choose whether to wear a shirt underneath the brace or not. If you choose to wear a shirt, a thin, athletic shirt works great!
- Check in with your team. Whether it’s family members, doctors, or us - your orthotist – make sure you check in and let us know any challenges you might be facing. Pectus carinatum can improve by wearing your brace, but it can also get worse if you aren’t wearing it. Reach out to us and we can help come up with strategies you feel comfortable with in order to get you back on track for your desired outcome!
Hear from Our Patients and Families:
- “We are both very happy with the results of the bracing and definitely think it was worth it! Zack is a freshman in college now and is a very confident, happy kid. When we really noticed his chest was an issue was when he didn’t want to go without his shirt on when we were at the lake, and he walked around wearing a life jacket to hide his chest. It became obvious quickly that we had to do something… We truly are so grateful for the work you did with him, and I know it was a cosmetic correction but it really made a difference!”
- “The summer of 2023 we noticed our 11-year-old son's chest was protruding. We were referred to U of M and he was diagnosed with pectus carinatum. We are 8 months into bracing and his chest measurements are improving on every visit. To be successful in the bracing process it comes down to how much your child is wearing their brace. Our son is eager to see results and that helps with his motivation to wear his brace. We are thankful for the great team at U of M!”
- “Wearing his chest brace has been a transformative experience, both physically and emotionally. Initially, he was unsure how it would feel, if it would make a significant difference, or if it was worth the stress and agony but I can confidently say it has exceeded his expectations…I’ve also seen a change in his confidence. The brace has not only helped him physically but also mentally. He feels more comfortable knowing that he’s taking proactive steps to improve the pectus condition… For anyone out there who might be struggling with a similar condition, he wants to be an example that change is possible. Wearing the brace has been challenging for him but certainly helped so far with building self-confidence too. If his experience can inspire even one person to seek out the help they need or feel less alone, then sharing his success story is worth it. “
Connect with a Pectus Carinatum Family
Have questions or would like to talk with a family who has experienced a pectus carinatum brace? Send us an email at jarichaz@med.umich.edu and we will connect you!
Make an Appointment
If you would like to learn more about bracing for pectus carinatum or to schedule an appointment for a consultation, please call 734-973-2400.