Spine & Chest

    Pectus Carinatum in Adolescents: Compressive Brace or Surgery?

    Is your child's sternum protruding? Pectus carinatum can be corrected with a compressive brace. Learn when it works and when surgery is needed. Milan.

    Medically reviewed: April 2026·Dott. Daniele Priano

    Quick Answers

    Does pectus carinatum get worse with age?
    Pectus carinatum may become more prominent during the pubertal growth spurt, when costal cartilage growth is maximal. After skeletal maturity the deformity tends to stabilize. Addressing the pathway during adolescence, when the chest wall is still remodelable, may offer more options compared to adulthood.
    When is a compressive brace useful?
    The compressive brace is considered in flexible forms, in patients still growing. The rationale is to apply gradual and prolonged pressure on the protruding area. Effectiveness depends greatly on deformity flexibility and adherence to the protocol, to be agreed case by case.
    Does pectus carinatum cause respiratory or cardiac problems?
    In most cases pectus carinatum is an **aesthetic and psychosocial** issue, not a functional one. Unlike pectus excavatum, it rarely compresses heart or lungs. The main reason families seek evaluation is the discomfort experienced by the adolescent, especially in contexts where the chest is exposed.
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    Pectus Carinatum in Adolescents: Compressive Brace or Surgery? - Pediatric Orthopaedics Milan Dr. Priano

    Pectus carinatum is an anterior protrusion of the sternum and/or costal cartilages caused by overgrowth of the chondrosternal cartilages. It is less common than pectus excavatum, predominantly affects males, and typically appears or worsens during the pubertal growth spurt (around 11-15 years). The visit assesses morphology, manual flexibility of the deformity, and psychosocial impact on the adolescent; advanced imaging is reserved for selected or pre-surgical cases. Care is built case by case: in flexible forms in growing patients a dynamic compressive brace may be considered, while surgery is reserved for rigid or resistant forms. Choices depend on flexibility of the deformity, age, the adolescent's experience, and the family's priorities.

    When to seek evaluation

    • Visible protrusion of the chest wall
    • Psychological discomfort related to appearance
    • Worsening during pubertal growth
    • Request for evaluation of treatment options

    What is evaluated

    • History and adolescent's experience
    • Clinical assessment of the chest wall
    • Manual flexibility testing under pressure
    • Advanced imaging only in selected or pre-surgical cases
    • Cardiac and respiratory evaluation when clinically indicated

    Treatment options

    • Observation and reassurance in mild forms
    • Dynamic compressive brace in flexible deformities in growing patients
    • Trunk muscle strengthening exercises
    • Surgical evaluation reserved for rigid or resistant forms

    Frequently Asked Questions

    Does pectus carinatum get worse with age?▼
    Pectus carinatum may become more prominent during the pubertal growth spurt, when costal cartilage growth is maximal. After skeletal maturity the deformity tends to stabilize. Addressing the pathway during adolescence, when the chest wall is still remodelable, may offer more options compared to adulthood.
    When is a compressive brace useful?▼
    The compressive brace is considered in flexible forms, in patients still growing. The rationale is to apply gradual and prolonged pressure on the protruding area. Effectiveness depends greatly on deformity flexibility and adherence to the protocol, to be agreed case by case.
    Does pectus carinatum cause respiratory or cardiac problems?▼
    In most cases pectus carinatum is an **aesthetic and psychosocial** issue, not a functional one. Unlike pectus excavatum, it rarely compresses heart or lungs. The main reason families seek evaluation is the discomfort experienced by the adolescent, especially in contexts where the chest is exposed.
    Can sports be played with pectus carinatum?▼
    Yes, sport is encouraged. Activities that strengthen trunk musculature (swimming, postural exercises, back work) can improve posture and overall appearance. There are no absolutely contraindicated sports. Even during a possible pathway with a brace, physical activity generally remains possible, according to case-specific indications.
    When is surgery considered?▼
    Surgery is considered in rigid cases that do not respond to bracing or in patients reaching evaluation after the end of growth. Various techniques exist, from more traditional ones (modified Ravitch) to minimally invasive ones (Abramson). Indication is always shared multidisciplinarily and openly discussed with the teenager and family.

    Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.

    Dott. Daniele Priano

    Have you noticed a chest deformity?

    For information or questions, contact me.

    PrenotaContatti

    Email: daniele.priano@ortopediaevolutiva.com

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