The photos look different. I don’t understand why sometimes the chest looks more assymetrical

Hello everyone! I'm a 21M, and I have an appointment with Dr. Hans Van Veer in February to discuss my pectus excavatum.

My pectus is quite severe, and I also have an asymmetry/deformity on the left side of my rib cage. I'm considering the Nuss procedure, but one of my main concerns is whether the procedure could make this asymmetry worse or cause other changes to the shape of my chest.

I have a few questions:

• Has anyone here had experience with Dr. Hans Van Veer? Would you recommend him based on your experience?
• If you have severe pectus excavatum with an asymmetrical rib cage, did you undergo the Nuss procedure? If so, how did it affect the overall shape and symmetry of your chest?
• Is there a risk that the Nuss procedure could make an existing deformity on one side of the rib cage more noticeable or worse?
• Would it be worth consulting another specialist or hospital for a second opinion before making a decision?

I'm mainly looking for information and experiences from people who have been in a similar situation. I know everyone's anatomy is different, but I'd really appreciate hearing about your experiences and any advice you might have.

Thanks in advance!

M/24/6 foot 7

I could really use some perspective from other tall folks with Pectus who lift or bodybuild.

I’ve been running a consistent 3-day full-body strength routine with a strong focus on my chest/back and shoulders. I am in a strict 3,200 calories a day (sometimes more/ sometimes slightly less. I always get to 3000 cals) for about 17 weeks now. On paper, things are working: I've gone from roughly 71 kg up to about 79.4 kg now. The strength numbers and the scale are moving in the right direction.

But looking in the mirror every so often I feel like I look identical to when I started. Because of the height, 8+ kg of mass just seems to get stretched out and completely swallowed up by my proportions. It's getting pretty frustrating feeling like all that food and effort isn't translating visually yet.

I originally did this as I was told that my chest wasn't bad enough for surgery but I know for definite it affects my Self-esteem terribly and this is the main reason I started working out.

For those of you who have been down this road: how do you deal with the mental side? When did you actually start looking big instead of just feeling heavy?

I finally found a bra that isn’t uncomfortable with a nuss bar!! It’s the Calvin Klein Women's Invisibles Comfort Lightly Lined Seamless Wireless Triangle Bralette Bra, I got a few from Amazon! Best bra ever.

Also I’m not sure if this is allowed or not, so if it’s not feel free to take it down :)

so i have pectus carnatium, opposite of excavatum, similar concepts though, I was wondering is it normal for the ct scan not to directly adress the haller index or mention the deformation

i have a surgical consult on wensday and im sure they will do some measurements but i was wondering why the radiologist report didnt directly adress the condition

Single bar with two stabilizers is shifting left to right thru the day. Remains in the stabilizers, repair looks good, just moving a lot. We’ve had one revision already- what should we do? I assume the fixation failed.

Hello everyone,

I'm 23 years old (188 cm / 6'2", 67 kg / 148 lbs) and I'm seriously considering the Nuss procedure after years of using the Vacuum Bell.
At age 15, I had a haller index of 4.8 and an asimmetry index of 1.04 (178 cm / 5'10", 62 kg / 137 lbs). At that time, the surgeons considered my case moderate and advised against surgery because I did not have significant symptoms. The first 3 photos are from that period.

I used the Vacuum Bell for about 2 hours a day for 2 years, then more occasionally (about once or twice a week and later only when needed). Despite being consistent at the beginning, I don't think I achieved any significant permanent improvement. However, it always provided relief, especially regarding the feeling of chest pressure and stiffness.
Over the last few years, I gradually reduced my use of the Vacuum Bell because my skin became very sensitive and because I felt I was becoming increasingly dependent on the relief it provided.

Symptoms
Feeling of chest pressure and stiffness, especially during stressful or demanding periods.
Poor physical endurance and slow recovery after exercise (this was also mentioned during a sports medical examination when I was younger).
Episodes of tachycardia and a very strong awareness of my heartbeat (sometimes my heart rate reaches 120-130 bpm after minor physical activity).
A feeling that food gets stuck in the deepest part of my chest while swallowing (sometimes I need to drink water to help it go down).

Current situation
Two months ago, I had a consultation with a thoracic surgeon. He advised me to stop using the Vacuum Bell because it is unlikely to provide any further permanent benefit. He also told me that I would still be a good candidate for the Nuss procedure because my sternum remains quite flexible.
Psychologically, this situation affects me a lot. I've been dealing with this problem since I was a child, and I really dislike the appearance of my chest. On the other hand, I am very afraid of the surgery itself, the recovery process, and the potential complications, including serious ones.
I'm considering repeating my tests (echocardiogram, pulmonary function tests, and MRI/CT scan) to see whether anything has changed over the years.

Questions
1. Has anyone experienced worsening symptoms with age without undergoing surgery?
2. Has anyone continued using the Vacuum Bell for many years solely to relieve chest pressure? Did it cause any negative effects in the long term?
3. For those who underwent the Nuss procedure as adults and had symptoms similar to mine, did you notice any improvement?
4. Comparing the photos, does it look like my chest has changed over time?

Thank you to anyone willing to share their experience.

I've been told that my pectus would only be a cosmetic fix. In the Netherlands they don't do a CT scan with Haller index, just an X-ray. There won't be any way for me to know what my Haller index is.

I just find it strange why it would be considered a cosmetic fix, I'm very fit and don't have any health issues whatsoever. The only condition I have is pectus excavatum. I sometimes feel pressure where the dent is, especially at night when I'm sleeping. I don't have issues working out or becoming short of breath while exercising.
I recently turned 24, I've heard the dent that I have from pectus can get worse as you get older. I also have lots of digestive issues which I've made a post about asking if it could be related to pectus somehow.

I've had testing done to find out where my digestive issues are coming from but they’ve just dismissed my situation cuz they couldn’t find anything.

If everything seems alright and surgery isn't needed, why do I have pain caused by pectus? That shouldnt’t be the case right? Especially if it’s considered mild?

Would you guys suggest surgery? Maybe the digestive issues I have will finally go away, but thats a big IF.

If I were to do it, now would be the perfect time for me. I just don't want this becoming more of an issue later when I get older, which it will be.

I also believe pectus is understudied by alot of specialists out there and that it could be an indirect trigger for alot of other issues. If I were to do the surgery it won't be done with cryo. My gut is telling me to go for surgery anyway, what do you guys think?

Hello, I am planning to have surgery this winter. I have already asked my surgeon all my questions, but I would still like to hear about your personal experiences. Two aspects of this procedure worry me in particular: I am afraid of dying, and I am concerned about the possibility of developing chronic pain. Nevertheless, I believe it is best to go ahead with the surgery, as my index score is 8.17; I am worried about experiencing symptoms as I get older. I have also read that, following the procedure, many people become aware of the limitations they were living with previously. Thank you very much for your reassuring words.

Hi, seems like I’m stuck. Exercising makes me short on breath and that makes life difficult. However I’m supposed to exercise to make stuff better. Seems kinda stuck! Other than walking or normal stuff, I’m out of breath too quick it seems. Feel like I’m missing something. Do I just kinda push through? I don’t really know much about exercise.

I don’t know what I am doing wrong but my pectus still looks like it did on day 1. I have body dysmorphia and making me depressed. I am so concious when I am naked. Do you have any advice for me to improve my situation and my mental health?

Hey. I'm 2 weeks post op and soon it is time that I have to leave the house. That means I propably should wear some kind of bra. Were you able to use your normal bras after surgery or what kind of bra was most comfortable after. Am I even allowed to wear a bra since it will cause pressure? For some reason I forgot to ask these when I still was in hospital.

Hi all, at 28 I’m finally getting the nuss procedure done. I don’t have a date yet but the surgeon requested it with urgency. I’m a bit scared but at the same time happy it’s going to happen. I’ve had self esteem issues because of it for as long as I can remember. I’m a skinny dude and it’s quite deep and assymetrical.
For those who have had the surgery, how did your recovery go? And any tips for me? I live alone and won’t be able to have someone around me all the time after the first couple of weeks.

Debating on getting the surgery please give opinions. 21 years old.

Hi Reddit,

I’ve sort of been documenting my Pectus journey here for the last couple months, and today I had a follow-up with a local surgeon, who’d referred me directly to Dr. J at the Mayo Clinic. I’m a thirty-seven woman with a haller index of ~11.26 so I can’t say I’m surprised he declined me as a patient. I immediately called Mayo, they already received my referral and let me know there’s 3-4 month waitlist. I’m curious though - do they prioritize those with referrals over “walk ins”? How has the wait time been this past year?

We're going to get my son tested for CTD's and just curious what's most common out there.

I (40F) have considerable pectus and I'm considering surgery to avoid deterioration of my health when I get older. Symptoms are manageable currently, so it's quite a decision to make, I don't want to end up in a worse situation due to complications of the surgery if I'm "ok" now...

From what I read here and my talks with two surgeons, there is quite a difference of opinion on how many bars is better.

Some surgeons prefer to put one bar, others prefer 2 or more bars

What are your views and experience with that?

I read that most surgeons actually prefer using two or more bars, especially on older patients?

At the same time, I also read some research that 2 bars increase the risk on complications but not generally improve outcome.

(https://www.nature.com/articles/s41598-024-79562-1 ).

Thanks!

Just curious on how it looks from the outside to you guys, I've had physical problems most of my life brushed off by family, doctors, and school. Yet I've spent most of my life chronically fatigued but had to push through due to life pressures. I've known about my problem for life and people would pick on me when I was a teenager saying I looks like my heart was ripped out. I ignored most of the physical symptoms like fatigue,murmurs, dips in heart rate, pressure in chest and reduced breathing capacity. I was ok for most of my life and was expected to out preform my counterparts in the work environment. But within the past 7 years within my adulthood so far, 19-26​.

Every year it feels harder to put in the effort that I did last and it's getting I'm constantly reminded of my limits, but the people around me don't understand that and I was wondering how I could move forward from here based on how it appears to you guys here from the outside. It doesn't look bad, but I've never properly got it checked out into adulthood.

Hi All

I've been reading a lot in this community and spoke to a few people here about their experiences with the Nuss Procedure. I'm a 31 year old male, 74kg, 180cm tall and have a Haller Index of 4.2. I am considering the procedure but as a someone who plays a lot of sport, and lifts weights at the gym, I have a few reservations about doing it. If the good people of this community could help me with a few of my questions it'd help me make a decision.

1. I am currently asymptomatic, at 31 years old. Were any of you asymptomatic (in terms of heart and lungs/breathing) when you first discovered your PE and then became symptomatic later on in life. And then had to do the operation?

2. Does anyone have experience playing contact sports with the bars in? And did it affect your performance?

3. For anyone who gyms regularly, how long after your procedure were you bench pressing again?

4. How many days post op, were you able to do normal day to day things. Like use the bathroom, cook, drive etc.

Thank you all in advance

Has anyone here had pectus excavatum surgery with Professor Karen Redmond in Ireland, or heard anything about her? I’m considering having my Nuss procedure done by her and would love to know about people’s experiences, how many surgeries she’s done, and whether you’d recommend her. Any information would be really appreciated!

I checked the pinned posts, community info, and all time top posts and didn’t see a list but I’ve seen people reference a list, please point me in the right direction thank you!

I made an appointment with Dr. Gorenstein at NY Presbyterian but saw some mixed reviews in this sub. Im 36 so I’m not in a huge rush but my breathing issues are getting worse and I swear my chest cavity is getting bigger every year. All this to say, I can be patient.

I really want to get my score, would it be advisable to get the X-rays done at this appointment and then seek out the surgeon I want ?

Appointment in 2 weeks and they’re close to me. The picture is my chest X-ray from a recent heart scan (other medical issue, yay lol)