Pectus Excavatum Repair (NUSS Procedure)

Daniel M. Bethencourt, MD is one of the few surgeons in the Southern California who performs the minimally invasive pectus excavatum repair. Over the years Dr. Bethencourt has performed hundreds of “NUSS” procedures  on patients of variaous ages (child-adult) who suffer from the pectus excavatum (or “sunken chest”) deformity.

minimally invasive repair pectus excavatumWhat is pectus excavatum?

Pectus excavatum is caused by an overgrowth of costal cartilage during chest wall development before birth. It is usually apparent by age 2 or 3 and can become more severe during later childhood and progress further with pubertal growth.

Who is at risk for pectus excavatum?

Pectus excavatum occurs more often in families where there is a family history of the abnormality. It is also four times more common in boys than girls and is associated with other muscle and bone (musculoskeletal) abnormalities, particularly scoliosis.

Is pectus excavatum dangerous?

No. Occasionally patients will have complaints of chest wall pain, increased incidence of Asthma, pneumonia or bronchiectasis. A person who has pectus pxcavatum can also experience difficulty breathing when exercising.

How is pectus excavatum repaired?

Minimally invasive pectus excavatum repair, known as the “NUSS” procedure, offers an effective, safe, and durable repair for the majority of patients. Under general anesthesia, a C-shaped metal strut is placed behind the breastbone and in front of the heart through a small incision on each side of the chest to create tunnels and small pockets. It is then rotated halfway around to elevate the breastbone and bend the cartilage segments of the ribs.

What happens after surgery?

  • It is important to begin mobilization early on. You will be helped to walk the day after surgery.  
  • It is important to keep your back straight.
  • Pain can be controlled with an epidural, Toradol, or other pain medications.
  • You should not return to work, go to the gym or engage in any contact sports such as football, hockey or boxing until after the postoperative visit with your surgeon.
  • Complete recovery takes up to two months.

Is the bar removed?

Yes. Two to three years following the initial procedure, the metal bar is removed. This procedure is done on an outpatient basis under general anesthesia and requires minimal pain medication and recovery time.