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Chest wall deformities affect thousands of people across the UK, impacting both physical health and psychological well-being. These conditions range from mild cosmetic concerns to more severe cases that can affect breathing and heart function.
Structural chest irregularities are anatomical abnormalities that affect the shape and appearance of the chest. These conditions can be present from birth (congenital) or develop during growth spurts in childhood and adolescence. The most common conditions include pectus excavatum (funnel chest) and pectus carinatum (pigeon chest), which together account for the vast majority of these irregularities.
These abnormalities occur when the costal cartillages connecting the ribs to the breastbone grow unevenly, causing the chest wall to develop an abnormal shape. While many mild cases don’t require treatment, more severe conditions can impact lung capacity, heart function, and cause significant psychological distress due to body image concerns.
The main types of structural chest abnormalities that Mr. Marco Scarci treats include:
The most common chest wall irregularity, where the breastbone and ribs grow inward, creating a caved-in or sunken chest appearance. This condition affects approximately 1 in 400 births and is more common in males.
Less common than pectus excavatum, this condition causes the breastbone to protrude outward, creating a bird-like chest appearance also known as pigeon breast. It typically becomes noticeable during adolescent growth spurts.
A rare variation where the lower portion of the chest protrudes while the upper portion remains normal.
A rare congenital condition where the breastbone fails to fuse properly during foetal development.
A rare condition that can cause severe chest wall irregularities and breathing difficulties, requiring specialist thoracic surgery intervention.
Pectus excavatum presents as a sunken appearance of the chest wall, where the breastbone and lower ribs appear pushed inward. The severity can range from mild cosmetic concerns to significant functional impairment. Patients may experience:
Shortness of breath during physical activity
Reduced exercise tolerance
Chest pain or discomfort
Heart palpitations
Frequent respiratory infections
Fatigue during exertion
The condition often becomes more pronounced during adolescence when rapid growth occurs. Some patients may also experience associated conditions such as mitral valve prolapse, congenital heart disease, or may be part of connective tissue disorders like Marfan syndrome or Poland syndrome. The rib cage structure can also be affected, leading to compensatory posture changes.
Beyond the physical symptoms, pectus excavatum can significantly impact a patient’s quality of life. Many individuals, particularly adolescents, experience body image issues and avoid activities that require removing their shirt, such as swimming or sports. This psychological impact can be as significant as the physical symptoms.
From a medical perspective, severe cases can compress the heart and lungs, reducing lung capacity and affecting cardiac function. A CT scan or chest CT helps assess the severity of the condition and determine whether surgical intervention is necessary for this most common chest wall irregularity.
Pectus carinatum causes the chest to protrude outward, creating a bird-like appearance. This condition typically develops during childhood and becomes more noticeable during adolescent growth spurts. Unlike pectus excavatum, pectus carinatum rarely causes significant functional problems but can cause considerable psychological distress.
The condition is often associated with connective tissue disorders and may have a family history component. Some patients may experience mild chest pain or tenderness, particularly during periods of rapid growth.
Treatment for pectus carinatum is often sought for cosmetic reasons rather than functional impairment. However, in some cases, the protrusion can cause:
Chest pain and discomfort
Breathing difficulties during exercise
Psychological distress and social anxiety
Postural problems
Early intervention with non-surgical treatments such as bracing can be highly effective, particularly in younger patients whose chest wall is still flexible.
Mr. Marco Scarci begins with a comprehensive physical examination to assess the severity and type of chest wall irregularity. The examination includes:
Visual assessment of chest wall symmetry
Palpation to identify structural irregularities
Assessment of breathing patterns
Evaluation of any associated conditions
Discussion of symptoms and functional limitations
Advanced imaging studies help determine the exact nature and severity of the structural abnormality:
Provide initial assessment of bone and costal cartillages structure, helping identify the extent of the irregularity and any associated conditions.
Offer detailed cross-sectional images that allow precise measurement of the abnormality and assessment of compression on internal organs. These CT scan evaluations are crucial for surgical planning.
Evaluate lung capacity and breathing efficiency to determine functional impact.
May be performed to assess heart function, particularly in cases where cardiac compression is suspected.
For certain types of structural chest abnormalities, particularly pectus carinatum, non-surgical treatments can be highly effective:
Custom-fitted braces or chest brace systems apply external pressure to gradually reshape the chest wall. This nonsurgical treatment is most effective in growing children and adolescents with flexible chest walls and represents an important nonsurgical treatment option.
For pectus excavatum, a vacuum bell device can be used to create suction that temporarily lifts the depressed chest wall. While not a permanent solution, it can provide temporary improvement in appearance.
Specific exercises can help improve posture and strengthen chest muscles, potentially reducing the appearance of mild structural abnormalities.
When non-surgical treatments are insufficient or inappropriate, surgical correction offers excellent results:
This minimally invasive technique for pectus excavatum repair involves inserting a curved metal bar (Nuss bar or pectus bar) beneath the sternum through small incisions on either side of the chest. The bar is positioned to push the breastbone into its normal position. This surgical repair technique has revolutionised the correction of pectus excavatum.
A traditional open surgery approach that involves removing abnormal costal cartillages and repositioning the breastbone. This procedure may be necessary for complex cases or when the minimally invasive approach is not suitable. This surgical repair method allows for direct correction of pectus conditions.
For severe cases of pectus carinatum that don’t respond to bracing, surgical procedures can reshape the protruding chest wall using techniques similar to those used for the correction of pectus excavatum. The severity of pectus excavatum or carinatum influences the decision-making process regarding treatment options.
Mr. Marco Scarci specialises in minimally invasive surgical techniques that offer several advantages over traditional open surgery:
Smaller incisions and reduced scarring
Shorter recovery time
Less post-operative pain
Reduced risk of complications
Faster return to normal activities
These advanced techniques represent the gold standard in chest wall abnormality treatment, providing excellent cosmetic and functional results with minimal disruption to the patient’s life.
Mr. Marco Scarci brings extensive expertise to the treatment of these conditions, having trained in advanced minimally invasive techniques including a fellowship in minimally invasive surgery at the University of Toronto, Canada. His approach combines technical excellence with a deep understanding of the psychological impact these conditions can have on patients. Working closely with pediatric surgeons when treating younger patients, he ensures comprehensive care across all age groups.
As a consultant thoracic surgeon with over 10 years of experience and affiliation with the Department of Surgery at leading London hospitals, Mr. Scarci has successfully treated hundreds of patients with various chest wall abnormalities. His expertise spans the full spectrum of conditions, from simple pectus conditions to complex chest wall reconstructions, including anterior chest wall irregularities and rare conditions like asphyxiating thoracic dystrophy.
Every patient receives a personalised treatment plan tailored to their specific condition, age, lifestyle, and treatment goals. Mr. Scarci works closely with a multidisciplinary team comprising specialist nurses, radiologists, and other healthcare provider professionals to ensure comprehensive care. Your healthcare provider will discuss all treatment options based on your individual needs.
The treatment approach considers:
Severity of the structural abnormality
Functional impact on daily activities
Psychological and social factors
Patient age and growth potential
Family history and associated conditions
Patient preferences and expectations
Recovery from chest wall irregularity surgery varies depending on the specific procedure performed:
Most patients can expect to return home within 2-3 days after surgery. Initial recovery involves pain management and gradual return to normal activities over 4-6 weeks.
Patients are typically advised to avoid heavy lifting and contact sports for several months to allow proper healing. While side effects are generally minimal with modern techniques, patients should be aware of potential complications including bar displacement in rare cases.
Regular follow-up appointments ensure proper healing and monitor for any complications. Patient stories from those who have undergone treatment often highlight the transformative impact on their quality of life.
The outcomes of chest wall irregularity surgery are excellent, with high patient satisfaction rates. Most patients experience:
Significant improvement in chest wall appearance and correction of any chest abnormality
Enhanced lung capacity and breathing function
Improved exercise tolerance
Increased confidence and quality of life
Excellent cosmetic results with minimal scarring
Reduced impact of any underlying chest abnormality on daily activities
The pectus bar used in minimally invasive procedures is typically removed after 2-3 years once the chest wall has stabilised in its new position. The bar removal procedure is generally straightforward and involves the same small incisions used for the initial surgery. Many patient stories document the excellent long-term results achieved through this approach.
Mr. Marco Scarci is recognised as one of the UK’s leading thoracic surgeons specialising in structural chest abnormalities. His expertise encompasses:
Advanced minimally invasive surgical techniques
Comprehensive treatment of all types of chest wall irregularities
Personalised care tailored to each patient’s needs
Extensive experience with both paediatric patients and adults
Access to state-of-the-art facilities at leading London hospitals
Commitment to achieving the best possible outcomes for every patient
Patients choose Mr. Scarci for his combination of technical expertise, compassionate care, and commitment to using the most advanced treatment options available. His approach ensures that every patient receives the highest standard of care from initial consultation through to complete recovery.
If you’re concerned about a chest wall abnormality, whether for yourself or a family member, Mr. Marco Scarci offers expert evaluation and treatment options. For those dealing with structural abnormalities of the chest, comprehensive assessment and modern treatment approaches can make a significant difference in both function and quality of life.
Ready to take the next step? Contact Mr. Marco Scarci’s team today to schedule your consultation and begin your journey toward improved health and confidence.
There are different types of congenital chest wall deformities. The most commons is the pectus excavatum, also called in simpler terms funnel chest. In this condition the anterior portion of the chest sinks in and forms like a funnel. There are different variant of it according to the severity of the deformity (mild- moderate and severe) and the shape of it. Some can involve just the bottom part of the chest others the entire breast bone, sometime the defect is wide and long and takes the name of grand-canyon variant. This deformity affects nearly 2/3 of all patients and is more prevalent in males. Another common variant is the pectus carinatum or also called pigeon chest. In this condition the breastbone sticks forward like the bow of a ship. It also has different grades of severity and sometime it can also be visible under clothes. This condition affects about the remaining 1/3 of the cases. Lastly there is a rare variant called pectus arcuatum which is a combination of the two previously mentioned defects. Very often this is wrongly diagnosed as pectus excavatum as the chest does sink in, but, more importantly, it also sticks out. It is very important to be familiar with this condition and having diagnosed properly as the wrong diagnosis might lead to the wrong treatment.
Symptoms varies greatly according to the type and severity of the defect. Some patients with a mild conditions have no physical symptoms at all or are very mildly symptomatic. Others with severe defects can experience shortness of breath and pain along the anterior rib cage, especially after exercise. This pain is quite non-specific and it is mostly related to an asymmetry in the rib cage that responds differently to mechanical stress. Shortness of breath is also rather common, but, unfortunately, it is difficult to diagnose it as most patients are young and fit at rest. The problems only become evident during sub-maximal exercise. In this category of patients a cardiopulmonary exercise test might be the best way forward to document the symptoms. Static lung function is not useful in this scenario, nor is a standard chest x-ray.
Marco Scarci is renowned for his expertise in thoracic surgery and lung cancer care. Patients consistently highlight his compassionate approach, clear communication, and exceptional skill in delivering personalized treatment plans. Many praise his ability to put them at ease during challenging times and commend the successful outcomes of their surgeries. His dedication to patient care and cutting-edge techniques has earned him glowing reviews and deep gratitude from those he’s helped.
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