Pectus Excavatum Treatment London
You’ve spent years covering it up. You don’t have to.
The pool parties you’ve avoided. The changing rooms that make your stomach sink. The T-shirts worn in August. Pectus excavatum — a sunken or hollow chest — affects around 1 in 400 people, and the majority are told at some point that “surgery isn’t indicated” or that it’s “only cosmetic.” Often, neither is true. Mr Scarci has corrected pectus in teenagers and adults up to their 40s. It is not too late. A consultation will tell you exactly what your options are.
Mr Scarci featured on the BBC programme My Naked Secret performing pectus excavatum correction surgery, bringing significant awareness to a condition that affects around 1 in 400 people. Watch the surgery video in the Videos section.
Pectus excavatum and pectus carinatum — what they are
Pectus excavatum (sunken chest)
The most common chest wall deformity — the breastbone (sternum) curves inward, creating a hollow or sunken appearance. In mild cases it is primarily cosmetic. In moderate to severe cases, the inward sternum can compress the heart and lungs, reducing exercise tolerance and causing breathlessness, chest tightness, and palpitations. Affects approximately 1 in 400 people; three times more common in males.
Pectus carinatum (pigeon chest)
The sternum protrudes outward. Less common than pectus excavatum. The functional impact is generally less significant, but the physical appearance causes considerable self-consciousness. Correction can be achieved surgically — the approach depends on severity and cartilage flexibility. Most patients present in teenage years or early adulthood.
When to consider surgical correction
- Exercise intolerance or breathlessness disproportionate to fitness level
- Chest tightness or palpitations during activity
- Reduced lung function or cardiac compression on imaging
- Haller index ≥3.25 on CT scan (severe)
- Paradoxical chest movement (chest moves inward on inhalation)
- Documented heart displacement or compression on echo
- Significant self-consciousness about appearance affecting daily life
- Avoidance of swimming, gym, or situations requiring removing clothing
- Psychological impact — body dysmorphia, social withdrawal
- Pectus carinatum with significant protrusion causing embarrassment
- Patient motivation and realistic expectations about outcome
- Previous non-surgical options considered (bracing for carinatum in teenagers)
The Nuss procedure — how it works
Minimally invasive chest wall correction
The Nuss procedure is the standard approach for pectus excavatum. It avoids the large incision and cartilage removal of the older Ravitch open procedure. Mr Scarci has performed this surgery on camera for the BBC and has published on chest wall reconstruction techniques.
Two small lateral incisions
A 2–3 cm incision is made on each side of the chest, in the mid-axillary line. No large chest opening required. A thoracoscope (keyhole camera) is inserted through one incision to guide the procedure under direct vision.
Bar passage behind the sternum
A curved steel bar is passed behind the sternum — threaded through the chest from one side to the other using the thoracoscope to guide it safely. The bar is carefully sized and shaped to match the patient’s chest anatomy beforehand.
Sternum elevated into position
The bar is flipped once in position, pushing the sternum forward into the corrected position. Stabilisers are attached to each end of the bar to keep it in place. The chest immediately takes on its corrected contour.
Hospital stay and recovery
Most patients remain in hospital 4–6 days for pain management. Pain from the chest wall expansion is the main challenge in the first week. Most patients return to normal activity within 6–8 weeks. The bar stays in place for 2–3 years while the cartilage remodels, then is removed under a short general anaesthetic.
Bar removal (2–3 years later)
Bar removal is a shorter, straightforward procedure. Once removed, the correction is permanent — the chest wall has remodelled into its new position. Long-term cosmetic and functional results are excellent in the majority of patients.
Pectus surgery — your questions
No. The Nuss procedure is performed in adults across a wide age range. Older adults do experience more pain in the post-operative period because the chest wall cartilage is less flexible, and the recovery may be somewhat longer. However, the procedure is entirely feasible and results are good. Age alone is not a contraindication. A CT scan and pre-operative assessment will confirm suitability.
The functional impact of pectus excavatum is frequently underestimated in primary care. A Haller index ≥3.25 on CT, documented cardiac displacement, or reduced exercise tolerance on testing are objective functional criteria — not “only cosmetic.” Even where the deformity is primarily cosmetic in terms of measured function, the psychological and quality-of-life impact is significant and is a legitimate surgical indication. A specialist assessment with proper imaging will clarify which applies to your case.
NHS funding for pectus excavatum surgery in adults is subject to individual funding request (IFR) processes and varies by ICB. Surgery is more commonly funded for cases with documented functional impairment (cardiac compression, reduced exercise tolerance on formal testing) than for purely cosmetic indications. Many patients in the UK choose to self-fund or use private insurance rather than navigate the IFR process. The practice can advise on the private pathway and costs, and can provide documentation to support an NHS funding application if relevant.
The Nuss procedure leaves two small scars on the lateral chest wall — typically 2–3 cm each. Over 12–18 months these fade significantly and are generally not visible in normal clothing. They are typically positioned in the natural shadow under the arm. Open Ravitch-type procedures leave more extensive scarring; Mr Scarci uses minimally invasive approaches wherever possible.
You don’t have to live with this.
A consultation gives you a clear picture of your severity, whether surgery is appropriate, and what the procedure and recovery involve — with no obligation to proceed.
020 7459 4367
