Introduction

Pectus excavatum is a congenital chest wall deformity where the breastbone (sternum) and several ribs grow abnormally, resulting in a sunken or caved - in appearance of the chest. This condition can range from mild to severe, with severe cases potentially affecting lung and heart capacity, leading to symptoms like fatigue, shortness of breath, chest pain, and a fast heartbeat. For adults with significant pectus excavatum, surgery is often the most effective solution to improve both physical function and appearance. In New York City, several hospitals are well - known for providing high - quality surgical treatment for adult pectus excavatum. This article will explore these hospitals, their surgical approaches, and other relevant details.

What is Pectus Excavatum?

Pectus excavatum is a relatively common congenital deformity, occurring more frequently in males. Approximately 40% of people with this condition have a family history of the defect. It may be present at birth or develop during puberty. The root cause is thought to be excessive growth of the cartilage connecting the ribs to the breastbone, which pulls the sternum inward. Mild cases may not cause any symptoms, but severe pectus excavatum can restrict lung expansion, reducing lung capacity and affecting heart function.

Diagnosis of pectus excavatum involves multiple tools. A visual examination of the chest is the most basic step. Auscultation is used to analyze the sounds of the heart and chest to detect any impact on their function. Other diagnostic methods include electrocardiogram (ECG), echocardiogram, pulmonary function testing, chest x - ray, CT - scan, and calculating the Haller index. A Haller index greater than 3.25 is generally considered severe, while a normal Haller index is around 2.5.

Surgical Treatments for Pectus Excavatum

Nuss Procedure

The Nuss procedure is a minimally invasive surgery performed under general anesthesia. Using video - assisted thoracoscopic surgery (VATS), the surgeon creates a horizontal passage underneath the sternum through two small incisions on the sides of the chest. A convex Lorenz pectus bar, custom - shaped to fit the patient's anatomy, is inserted through this passage and then turned to push the sternum outward. The bar must stay in place for at least three years while the chest contour reforms. After this period, the bar can be removed as an outpatient procedure. This procedure was originally developed for children but has also been successfully used in adults, with results comparable to the modified Ravitch repair.

Modified Ravitch Repair

This procedure, also done under general anesthesia, uses a horizontal incision. The surgeon removes small pieces of deformed chest cartilage and repositions the protruding ribs and sternum. Titanium bars are then secured to the ribs and sternum to support the repaired chest architecture. Unlike in the past, the current bars can be left in place permanently, eliminating the need for a second operation to remove the supports.

Hospitals in New York City for Adult Pectus Excavatum Surgery

NYU Langone Hospitals

NYU Langone has a team of dedicated doctors for treating pectus excavatum. Their doctors are committed to providing the most advanced and personalized care. The hospital is recognized for its high - quality medical services and experienced surgical team. The team stays updated with the latest surgical techniques and research in the field of pectus excavatum treatment. This allows them to offer patients the best possible treatment options based on their individual conditions. They also focus on comprehensive pre - and post - operative care, which is crucial for a successful recovery. You can browse their list of providers on their official website here and schedule an appointment online.

NewYork - Presbyterian/Queens

The thoracic surgery program at NewYork - Presbyterian/Queens is one of the most sophisticated minimally invasive thoracic surgery programs in the world. The hospital has earned a three - star rating from the Society of Thoracic Surgeons (STS) for patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures, which reflects its high - quality surgical care. Their thoracic surgeons, in collaboration with Weill Cornell Medicine, are well - trained in cutting - edge techniques, including the minimally invasive Nuss procedure for pectus excavatum. They also provide comprehensive care before, during, and after surgery, with a multidisciplinary team that includes thoracic surgeons, medical and radiation oncologists, pulmonologists, and more. The majority of patients can undergo minimally invasive surgery, which results in less blood loss, less postoperative pain, shorter hospital stays, and quicker recovery. You can contact them at 718 - 670 - 2707, located at 56 - 45 Main Street, Flushing, NY 11355.

Columbia University's Surgical Lung & Chest Care Program

As part of Columbia University Irving Medical Center and New York - Presbyterian, this program is consistently named one of New York's top hospitals and one of the top ten medical centers in the nation. The program provides the most up - to - date options for all chest conditions, including pectus excavatum. Dr. Lyall A. Gorenstein, a thoracic surgeon affiliated with this program, specializes in minimally invasive thoracic surgery and pectus excavatum treatment. The hospital is a leader in the field, with contributions such as developing the largest lung transplant program in the North Atlantic. For existing patients, you can call (212) 305 - 3408, and for new patients, call (212) 304 - 7535. The main location is at the Herbert Irving Pavilion, 161 Fort Washington Avenue, 3rd floor, New York, New York 10032.

Mount Sinai Hospitals

Mount Sinai offers pectus excavatum repair services. There are two main types of surgeries they perform: open surgery and closed (minimally invasive) surgery. In open surgery, the surgeon makes a cut across the front of the chest, removes the deformed cartilage, repositions the breastbone, and may use a metal strut to hold it in place. The strut is removed after 6 to 12 months. The closed method, mostly used for children but also applicable to adults in some cases, involves making two small incisions on each side of the chest, inserting a curved steel bar under the breastbone to lift it, and leaving the bar in place for at least 2 years. Mount Sinai has experienced surgeons and a comprehensive pre - and post - operative care system to ensure the best possible outcomes for patients.

Comparative Analysis of the Hospitals

Pre - operative Considerations

Before undergoing pectus excavatum surgery, a complete medical exam and various medical tests are necessary. These typically include an electrocardiogram (ECG) and possibly an echocardiogram to evaluate heart function, pulmonary function tests to check for breathing problems, and a CT scan or MRI of the chest. Patients should inform the surgeon about all the medications they are taking, including over - the - counter drugs, herbs, vitamins, and any supplements, as well as any allergies they may have to medicine, latex, tape, or skin cleanser. About 7 days before surgery, patients may be asked to stop taking certain blood - thinning drugs such as aspirin, ibuprofen, naproxen, and warfarin. It is important to follow the surgeon's instructions regarding which drugs to continue taking on the day of surgery. On the day of surgery, patients are usually asked not to eat or drink anything after midnight the night before.

Post - operative Recovery

The recovery process after pectus excavatum surgery varies from person to person. Most patients stay in the hospital for 3 to 7 days, depending on the extent of the surgery and their overall recovery progress. Pain is common after surgery. In the first few days, patients may receive strong pain medicine through an intravenous (IV) line or an epidural catheter. After that, pain can usually be managed with oral medications. Patients may have tubes in the chest around the surgical cuts to drain extra fluid, which are removed once the drainage stops, usually after a few days.

Early mobilization is encouraged. The day after surgery, patients are typically asked to sit up, take deep breaths, and start walking. Initially, patients need to avoid activities like bending, twisting, or rolling from side to side. Gradually, activities can be increased as the recovery progresses. Patients should follow all the post - operative care instructions provided by the hospital, including taking any prescribed medications, attending follow - up appointments, and engaging in any recommended physical therapy.

Success Rates and Prognosis

Surgical repair of pectus excavatum has excellent success rates. In the majority of cases, cardiovascular and lung function return to near - normal levels after surgery. The surgery also significantly improves the appearance of the chest, which can have positive psychosocial effects on patients, especially in terms of self - confidence and body image. However, there are still some risks associated with the surgery, such as reactions to medicines, breathing problems, bleeding, blood clots, infection, injury to the heart, lung collapse, pain, and the possible return of the deformity. Overall, with proper pre - operative evaluation, skilled surgical teams, and comprehensive post - operative care, most patients can expect a good recovery and long - term improvement in their condition.

Conclusion

In 2025, New York City offers several excellent options for adult pectus excavatum surgery. Hospitals like NYU Langone Hospitals, NewYork - Presbyterian/Queens, Columbia University's Surgical Lung & Chest Care Program, and Mount Sinai Hospitals are equipped with experienced medical teams, advanced surgical techniques, and comprehensive care systems. If you or someone you know is considering pectus excavatum surgery, it is crucial to research these hospitals, consult with their doctors, and make an informed decision based on individual needs and preferences.

We encourage you to share this article with others who may be interested in pectus excavatum surgery in New York City. If you want to learn more about this topic or related medical conditions, you can explore other resources on our website or contact the hospitals directly for further information.