Pectus excavatum, body image and confidence
By Javier Santana, founder of Pectus Academy · Updated October 2026
Short answer: distress about your own chest is a recognized consequence of pectus, and it has been measured in studies: it affects body image, self-esteem and quality of life, and it can weigh more than physical limitations when deciding whether to get treated. It is not vanity, and it is not just you.
What do the studies say?
| Study | Who | What it found |
|---|---|---|
| Steinmann et al., 2011 | 71 people with pectus excavatum, 19 with pectus carinatum and 82 with no deformity | Body image was highly disturbed in patients. Dissatisfaction with their own image was linked to worse mental quality of life and lower self-esteem |
| Kelly et al., 2008 | 264 patients aged 8 to 21 and 291 parents, at 11 hospitals, before surgery and one year later | Body image difficulties fell from 2.30 to 1.40 on a 4-point scale where higher is worse. 97% felt the operation had improved how their chest looked |
In the second study, parents also saw their children's emotional difficulties go down (from 1.81 to 1.24), along with social self-consciousness (from 2.86 to 1.33).
What does it look like day to day?
Mayo Clinic lists distress about chest appearance among the symptoms of pectus, and notes that many people avoid activities like swimming and take on a hunched posture. Skipping the pool or the beach, choosing clothes so it does not show, or hunching to hide it are some of the ways people live with it.
Does surgery improve body image?
In the Kelly study, yes, and clearly. Two caveats: these were patients who had chosen surgery, with no comparison group, and they were asked just one year later. It does not say what would have happened without surgery.
What about without surgery?
We have not found studies measuring how body image changes with exercise or posture alone. The closest data point is a small trial in which boys who did physical therapy on top of using the vacuum bell were more satisfied than those who only used the bell.
In my case, working on my posture changed how I perceive my body: I felt better about how I looked and better overall, with more confidence. That is my experience, not proof of what will happen to you.
What can help?
- Getting well informed: knowing what it is, what the options are and what to expect from each one removes uncertainty.
- Getting checked: ruling out an effect on the heart or lungs takes a weight off.
- Talking about it: with the people around you, your doctor or other people with pectus. Mayo Clinic mentions online support groups and forums.
- Seeking counseling if you need it: Mayo Clinic notes it may help some kids and teens feel better about themselves.
Apart from what we cite from Mayo Clinic, these are general pointers, not results from pectus studies.
When should you seek professional help?
If distress about your body takes up a large part of your day, leads you to avoid relationships, school or work, or comes with a sadness that does not lift, talk to your doctor or a mental health professional. Asking for help with this is as legitimate as asking for help with a physical symptom.
What we know and what we don't
What we know
- The impact on body image is real and has been measured.
- In patients who had surgery, body image had improved a year later.
What we don't know
- How much body image changes with posture, exercise or the vacuum bell.
- Which kind of psychological support works best for people with pectus.
Keep reading
- Visual improvement vs structural correction
- Pectus excavatum in adults
- Pectus in children and teenagers: a guide for parents
If you want to start with something concrete, download the free guide to the 4 posture mistakes.
This content is educational and does not replace the advice of a healthcare professional. We do not promise a specific result.
Sources
- Steinmann C, et al. Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image. European Journal of Cardio-Thoracic Surgery, 2011;40(5):1138-1145.
- Kelly RE Jr, Cash TF, Shamberger RC, et al. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study. Pediatrics, 2008;122(6):1218-1222. doi.org/10.1542/peds.2007-2723
- Mayo Clinic. Pectus excavatum: symptoms and causes, updated March 14, 2025. mayoclinic.org
- Mayo Clinic. Pectus excavatum: diagnosis and treatment, updated March 14, 2025. mayoclinic.org
- Alaca N, Alaca I, Yuksel M. Physiotherapy in addition to vacuum bell therapy in patients with pectus excavatum. Interactive Cardiovascular and Thoracic Surgery, 2020;31(5):661-668. doi.org/10.1093/icvts/ivaa161
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