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Pectus carinatum is a chest deformity in which the sternum and ribs protrude abnormally. Also called pigeon chest, it is caused by an abnormal growth of cartilage. Though pectus abnormalities are not rare, pectus carinatum is one of the less common types. It affects men about four times more than women.
Pectus carinatum appears most often in males undergoing puberty, in whom it arises very quickly. The second most common appearance of pectus carinatum is at birth. Rarely, the deformity may arise as a complication of open heart surgery.
When it is a birth defect, the deformity worsens as the child ages. Congenital pectus carinatum is often accompanied by scoliosis, or curvature of the spine, and sometimes by mitral valve prolapse, a heart valve deformity, or by connective tissue disorders, particularly in the cardiovascular system. Pectus carinatum causes abnormal breathing, leading to decreased stamina, shortness of breath, asthma, and fatigue.
The main medical reatments for pectus carinatum are an external brace and corrective surgery. A brace is typically used for children, in whom it usually shows excellent results. The brace is worn under the clothing and features front and back plates that are held together by aluminum bars and tightened to compress the sternum and ribs. It must be worn for 14 to 24 hours a day depending on the severity of the condition.
Surgical treatment is reserved for adult patients and severe cases. It makes use of steel bars inserted in the chest to correct the position of the sternum. After the deformity has been corrected, the bars are surgically removed. The most common method is the Ravitch technique, but the less invasive Nuss technique can also be used if the deformity is symmetrical.
Some male patients who do not undergo medical treatment improve the appearance of pectus carinatum through bodybuilding, by covering up the protruding pectus with chest muscles. While this technique is not harmful, it only addresses the cosmetic aspect of the condition, and any cardiovascular conditions will persist. Females with the deformity sometimes seek breast augmentation surgery for the same reason.