Also known as: pectus carinatum, pectus excavatum or combination chest wall deformity surgery.
What is the Ravitch procedure?
Chest wall deformities are divided into 3 major categories:
- Pectus excavatum (a sunken-in chest)
- Pectus carinatum (chest that protrudes outward)
- Combination chest wall deformity (when one side of the chest protruding while the other side is caved in)
The Ravitch procedure is a surgery that can correct all these conditions. It was used extensively in the past but has given way to other non-surgical methods as the first choices of treating chest wall deformities in most cases today.
What happens during the Ravitch procedure?
During the Ravitch procedure an incision is made in the patient’s chest, either vertically or horizontally depending on the specific deformity. Then the surgeon will expose the rib cage by retracting the pec muscles (pectoralis majors) to expose the ribs and sternum (breast bone).
The surgeon will remove the cartilages connecting the ribs to the sternum, as these cartilages are what is causing the chest to bow out or sink in. Finally, the sternum is repositioned before the incision is closed.
Over the next few months, the cartilages will regrow in the proper position. Sometimes, the surgeon may brace the sternum in place with a small metal strut, and this is usually removed in about 6 months in an ambulatory procedure.
Is any special preparation needed?
Imaging tests are often required prior Ravitch procedure. A cardiology evaluation and pulmonary function tests are sometimes helpful. The patient will be asked to work on good posture in the weeks leading up to surgery. Immediately before operation, the patient may need to avoid food, drink and certain medications before the procedure.
What are the risk factors?
Infection, pain, bleeding, difficulty moving, pneumonia, cosmetic imperfection and damage to surrounding organs and tissues are potential risks of Ravitch procedure, although these things are uncommon.
What is the recovery like?
Following the surgery, the patient will usually spend several days in the hospital, during which time the pain team assists with medications to keep the child comfortable. Breathing exercises and physical therapy are key components to a safe discharge. Most patients are back to their usual activities of daily living in a week or two, with full contact sports in 3 months.
Florida's Leader in the Treatment of Chest Wall Deformities in Children and Teens
Nicklaus Children's Hospital has long been a leader in treatment of chest wall deformities. Over the decades, hundreds of patients have enjoyed the physiologic and esthetic benefits of chest remodeling and chest deformity correction surgeries. The team of pediatric surgeons is experienced in performing the Ravitch Procedure as well as the minimally invasive Nuss Procedure.
Reviewed by: Cathy Anne Burnweit, MD
This page was last updated on: April 06, 2021 10:17 AM
Learn more about
Pectus carinatum, also known as pigeon chest, is a chest wall deformity in which the sternum (breastbone) and ribs protrude. It may be caused by excessive growth of cartilage.
Chest Wall Deformities
Conditions that cause physical abnormalities of the chest are known as chest wall deformities. The most common are pectus excavatum (sunken chest or funnel chest) and pectus carinatum (pigeon chest).
Pectus excavatum, Latin for "hollowed chest," is the most common chest wall deformity. In severe cases, pectus excavatum can affect the heart and lungs, while less severe cases often impact a child's or teen's self-image.
Chest Bracing Therapy
Chest bracing therapy is a treatment used in children with mild or moderate protruding chest. This therapy involves using an external brace to reshape the chest into a more conventional contour.