Does the vacuum bell work in adults? What is known and what isn't

By Javier Santana, founder of Pectus Academy · Updated October 2026

Short answer: no studies properly measure how well the vacuum bell works in adults. It has been used in people up to 61 years old, but the published series mix ages and most patients are children and teenagers. The reasonable expectation is a longer treatment and a less certain result than in a teenager.

What data is there?

  • Basel, 2011: 133 patients aged 3 to 61, with a median age of 16. In other words, most were young.
  • Basel, 2016: for teenagers and adults with a moderate dip, deeper than 3 cm, a treatment of 24 to 36 months with close follow-up is proposed. Severe, asymmetric pectus with a stiff chest wall is considered a risk group for failure.
  • Amsterdam, 2025: in 259 patients, age was not significantly linked to success.
  • Scottish assessment, 2025: it focuses on children and teenagers and does not address adults.
  • Mayo Clinic: describes it as a treatment for children and teenagers.

Why would it be different in an adult?

Studies point to better results when the chest is flexible, and a stiff chest wall is one of the described factors for failure. The chest usually becomes less flexible with age. That does not mean it cannot work; it means nobody has measured properly how much.

If you are an adult considering it

  1. Start with a doctor. In the published series, patients have an electrocardiogram and an echocardiogram before starting. It is contraindicated with musculoskeletal disorders, blood vessel disease, clotting problems or heart disorders.
  2. Think in years, not weeks. Published timelines for adults run from 24 to 36 months.
  3. Expect daily use. You start with 30 minutes twice a day and build up to several hours. Some adults wear it for up to 8 hours during the working day.
  4. Measure progress. In the series, patients are reviewed every 3 to 6 months, with photos and depth measurements. In Basel, 25 of 140 patients stopped because of unsatisfactory results after 15.7 months on average: if nothing changes, rethinking it is reasonable.

What we know and what we don't

What we know

  • It has been used in adults up to age 61, with no outcome or safety data broken down by age.
  • Consistency and wearing time weigh heavily on the result.

What we don't know

  • What percentage of adults improve, and by how much.
  • Whether the improvement lasts after stopping.

Keep reading

This content is educational and does not replace the advice of a healthcare professional. We do not promise a specific result.

Sources

  1. Haecker FM. The vacuum bell for conservative treatment of pectus excavatum: the Basle experience. Pediatric Surgery International, 2011;27(6):623-627.
  2. Haecker FM, Sesia S. Vacuum bell therapy. Annals of Cardiothoracic Surgery, 2016. annalscts.com
  3. van Braak H, de Beer SA, al Ghouch Y, et al. 15 Years of Vacuum Bell Therapy for Pectus Excavatum: Long-term Outcomes and Influencing Factors. Journal of Pediatric Surgery, 2025;60(2):161891.
  4. Scottish Health Technologies Group. Vacuum bell device for the correction of pectus excavatum, June 2, 2025. shtg.scot
  5. Mayo Clinic. Pectus excavatum: diagnosis and treatment. mayoclinic.org

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