Chest wall deformities in children encompass a broad spectrum of disorders but pectus excavatum and carinatum are by far the most common. They seldom cause significant cardiopulmonary symptoms and have long been thought to be purely aesthetic. Surgical approaches to the repair of these deformities were historically morbid and could themselves cause unsightly scars. However, since the publication of a minimally invasive repair pectus excavatum by Donald Nuss in 1998, the demand for correction of all kinds of chest wall deformities have increased exponentially.1 Meanwhile, non-surgical approaches have not received equal attention despite reasonable results in select patients.

In this review, we will describe new advances in the non-surgical approach to management of pectus excavatum and carinatum. Our goal is to equip surgeons with evidence-based knowledge of the options available to provide a patient-centered approach to treatment.