Chest Wall Surgery at the Orthopedic Surgeon

Who needs chest wall surgery?

Most people who get chest wall surgery fall into one of a few groups.

• Teens and young adults with pectus excavatum. A doctor usually waits until the chest is mostly grown. Surgery is offered when the dent is deep enough to press on the heart or lung, cause shortness of breath during exercise, or strongly affect how a young person feels about their body.
• People with pectus carinatum that did not respond to a brace. Bracing works well for many growing teens. When the chest stays pushed out after bracing, or growth is finished, surgery can flatten it.
• Anyone with a tumor in a rib or the breastbone. Bone tumors of the chest wall, both cancers and non-cancers, often need the affected piece removed and the gap rebuilt.
• People with several broken ribs (flail chest) from a car crash or fall. When a section of chest wall floats free and makes breathing painful or unsafe, surgeons can plate the ribs back together.
• People with a deep chest infection or a wound that destroyed bone or muscle and needs reconstruction.

How do you prepare for chest wall surgery?

Good preparation lowers your risk and speeds healing. Your surgical team will walk you through the exact steps, but most plans include the following.

• Imaging. Expect a CT scan or chest X-ray so the surgeon can map your ribs and sternum and plan the repair.
• Heart and lung testing. You may get an echocardiogram, a lung function test, or an EKG, especially for pectus repair where the heart can be compressed.
• Blood work. A standard panel checks your blood count and clotting before any major operation.
• Medication review. Tell your team about every drug and supplement. You will likely stop blood thinners, aspirin, and certain anti-inflammatory drugs for several days before surgery. Ask exactly when.

Stop smoking and vaping. Nicotine starves healing tissue of oxygen and raises the chance of a wound problem or infection. Even a few weeks smoke-free helps.

How is chest wall surgery done?

Chest wall surgery is done under general anesthesia, so you are fully asleep and feel nothing. The exact steps depend on what is being fixed.

For pectus excavatum (the minimally invasive Nuss repair):

• The surgeon makes one small cut on each side of the chest.
• A tiny camera guides a curved metal bar behind the sternum.
• The bar is flipped to push the sunken chest outward into a normal shape.
• The bar stays in place, usually for 2 to 3 years, then comes out in a short second procedure.

The open Ravitch repair is used in some pectus cases. The surgeon removes the overgrown cartilage through a cut across the chest, repositions the sternum, and may place a small support bar or plate.

For tumors, fractures, or reconstruction:

• The surgeon removes diseased bone or the tumor with a clear margin, or plates broken ribs with titanium screws.
• If a large piece of chest wall is removed, the gap is rebuilt with a mesh patch, a rib graft, or a flap of the patient's own muscle to keep the chest stable and protect the lungs.

A breathing tube supports you during the operation, and most people have a small chest tube afterward to drain fluid and let the lung re-expand. The whole operation usually takes 2 to 5 hours.

What is recovery like?

Recovery takes patience. Your chest needs time to settle into its new shape and for bone and cartilage to knit.

What are the risks and warning signs?

Chest wall surgery is safe in trained hands, but it is a major operation, and there is no safe home or do-it-yourself version. Pressing, bracing, or trying to reshape your own chest with online gadgets can crack cartilage, bruise the heart sac, or hide a problem that needs real treatment. A protruding or sunken chest is sometimes the visible sign of a tumor or a connective tissue disorder. Only imaging and a doctor's exam can tell for sure.

Known risks of the surgery itself include:

• Infection at the wound or around hardware.
• Air or fluid around the lung (pneumothorax or effusion) that may need a tube.
• Bleeding during or after the operation.
• Bar shift in a Nuss repair, which can require a return to the operating room.
• Lasting pain or numbness near the scars in a small number of people.
• Return of the deformity, more likely if surgery is done before the chest finishes growing.

Call your surgeon or seek care right away if you have any of these after surgery:

• A fever over 101 degrees Fahrenheit, or redness, swelling, or pus at a cut.
• Sudden trouble breathing or sharp chest pain that gets worse.
• A popping feeling or a sudden change in your chest shape, which can mean a bar has moved.

These warning signs are the reason recovery is supervised. Do not wait them out at home.

Does chest wall surgery work?

Results are good for most people, especially with pectus repair. Most large reviews of pectus excavatum surgery put patient satisfaction above 90 percent, and the result typically lasts for years. Many people also breathe and exercise more easily once the chest no longer presses on the heart and lung.

What success looks like depends on why you had surgery:

• Pectus repair: a flatter, more even chest, less shortness of breath on exertion, and a confidence boost that many teens and young adults describe as the biggest change.
• Tumor removal: a clear margin around the growth and a stable, protected chest wall after reconstruction.
• Rib stabilization: less pain, easier breathing, and a faster return to normal life than letting many broken ribs heal on their own.

Results hold best when surgery is timed well, the surgeon is experienced, and you follow the activity limits during healing. Doing the operation too early, before the chest is grown, raises the chance the shape comes back.

What does chest wall surgery cost?

Chest wall surgery is a major operation, and the price reflects the operating room time, the surgeon, the anesthesia, the hospital stay, and any hardware like a bar or titanium plates. What you actually pay depends far more on your insurance than on the sticker price.

When the surgery treats a tumor, broken ribs, an infection, or a deformity that causes real symptoms, it is medically necessary, and most insurance plans cover it. Get prior authorization in writing before your surgery date so you are not surprised. If a plan calls a pectus repair cosmetic, your surgeon can usually appeal with the CT measurements and your symptoms.

To find the right surgeon:

• Look for a board-certified thoracic or orthopedic surgeon who lists chest wall surgery or pectus repair among their procedures.
• Ask how many of these operations they do each year. Volume matters for this surgery.
• Children and teens are best treated at a center with a pediatric surgery team.

Our directory lists tens of thousands of orthopedic surgeons across the US so you can find one near you and check their background before you book.

Ranges cover the surgeon, anesthesia, hospital stay, and hardware for a typical chest wall repair. A tumor removal with major reconstruction, or a stay in intensive care, can run higher. Always confirm prior authorization and your out-of-pocket estimate with your plan and the hospital billing office before your surgery date.

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Medical disclaimer: This content is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you have a medical emergency, call 911. Our editorial standards