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Facts about Pectus Deformities

Facts on Pectus Excavatum: 

- An open surgical procedure called "The Ravitch Technique" has been used by many surgeons for the correction of pectus excavatum deformity. Some surgeons still use this procedure. All the deformed bones and cartilages are removed in this procedure. Standard operation time is 2 to 4 hours. The deformity might reoccur 7%.


-"The Nuss Procedure" was used successfully for the correction of pectus excavatum for the first time in 1987. Donald Nuss in an American surgeon who developed this technique, thus the operation is called "The Nuss Procedure"

-The ideal age interval for "The Nuss Procedure" is between 10 to 16 years.

-"The Nuss Procedure" has been performed up to 36 years of age in our clinic successfully. The oldest patient reported in medical literature was 47 years old.

- In "The Nuss Procedure", steel-nickel alloy bars ranging from 16 to 40 cm are used for the correction of pectus excavatum

- In "The Nuss Procedure", bars are fixed under the skin, and are not screwed on the bones.

- The bars that are implented are removed 2 to 4 years after the operation under general anestesia.

- Epidural analgesia is routinely used for pain management.

- Amount and size of the bars that are going to be implanted are decided during the operation. Older age and larger deformities might require 2-3 bars.

-The procedure is performed under general anestesia and takes approximatly 30 minutes.

-The cost for the nuss procedure is between 10.000 to 15.000 TL (8.000-10.000 $)

-Cost of the operation is payed by the Turkish government social security. (SGK)

-Private health insurance companies don't pay for the procedure.

- Patiens undergoing the nuss procedure stay in the hospital for 5 days. They should home rest for 2-3 weeks. The patients who decide on having the procedure must accept to be away from work or school for at least a month.  

-All the patients and their families should discuss about the operation with their surgeon and also with other patiens who underwent this procedure and their families.

-The Nuss Procedure is being performed in many different cities and by many surgeons in Turkey.

- It would be wise to choose an experinenced clinic (at least 20 cases) to have the operation.

-Pectus Excavatum deformity is mostly familial,thus there is probably a genetic defect present.

-Echocardiography and computerized chest tomography are important tools to access cardiac and intrathoracic malformations before the operation.

-Most of the patients decide to get an operation because of social and pshychological reasons. Since the deformities are fixed right after the operation, the patients are mostly relieved of their social and pshychological problems rightaway.


-Patients with pectus excavatum hate to go to the sea or the beach becase they are ashamned of their deformed bodies. They hate windy weathers because wind makes their clothes stick on their chests.


- Pectus excavatum does not effect life expectancy of a person. It only might effect effort capacity of a patient if he/she has a deep deformity.

- There might be problems with heart valves of the patients with pectus excavatum, and this situation can only be confirmed with echocardiography.


- Patients undergoing "The Nuss Procedure" turn back to their dailiy routines after 3 months. They do not feel the implanted bars after 6 months, and they can do every physical activity they want (except for boxing, karate exc.)


- Patient undergoing this operation can do their manditory military duties.


- The implanted bars might trigger the alarms in shopping malls and airports. Patiens should always carry their implant notification cards with them at all times.


Do you know these facts about Pectus Carinatum?


-Pectus Carinatum doesn’t affect the quality of life.


-Operation is totaly based on cosmetic reasons.


-The reason of occurence is mostly genetic.


-In the old days ,the operation was performed with the Ravitch Tecnique (Open Technique)


-Like NUSS also in Pectus Carinatum minimally invasive technique called ABRAMSON can be performed by establishing a steel bar  infront ot the deformed sternum.


-In Turkey,this operation was first performed at Marmara University Medical Faculty Thoracic Surgery Clinic.


-At present this operation can be performed only at Marmara University Medical Faculty and Dokuz Eylül University Medical Faculty.


-Duration of the operation is 30 minutes.


-The operation is easier  than NUSS and is based on the princible of establishing a short bar under the skin in front of the sternum without opening the thorax.


-Epidural catheter is placed for pain.


-Duration of hospitalisation is 5 days.


-After being discharged, 2-3 weeks of rest is needed.


-The persons decided to have this operation may need to keep away from their job or school for around 1 month.


-Cost of the operation is paid by the national insurance company.


-Cost of the operaion is NOT paid by private insurance (when performed at the university).


-Cost of ABRAMSON operation is between 10.000-15.000 Turkish Liras.


-The oldest patient that we operated with Abramson Technique was 33 years old.