Adolescents with “Funnel Chest” May Experience Psychological Distress

Funnel chest is a term used to describe the medical condition known as Pectus excavatum (PE), a deformity of the chest wall that occurs in one of every thousand children. “It is well known that children with PE are affected by their body image, that they often experience embarrassment, have low self-esteem and feelings of stigma,” said Susanne Habelt of the Department of Pediatric Surgery at the University Children’s Hospital in Basle, Switzerland. “These psychological criteria influence the patient’s life deeply.” She added that although recent studies have looked at how surgery affects the quality of these children’s lives, few researchers have examined the psychological symptoms related to PE, both before and after surgery. “With this as background the aim of our evaluation was to perform an extended psychological status in order to establish a psychological indication for treatment,” said Habelt.

Habelt and her colleagues examined 10 adolescents with PE for their study. The teens underwent physical and psychological evaluations and were all offered their choice of invasive surgery to correct the deformity, or non-invasive vacuum treatment to extend their chest wall. The parents and teens were asked about psychological stress, anxiety, shyness and self-esteem resulting from the PE. “Overall, 8 patients had psychological limitations especially concerning the dimensions attractiveness, self-esteem and somatization,” said Habelt. “Eight children shied away from presenting their body for instance when going swimming or doing sports. This resulted in in-creased insecurity, anxiety and denegation of their own body.”

Habelt noted that the results were not surprising. “It is well known that patients with PE often experience embarrassment and shame over the perceived differences in their physical appearance and that this can lead to lowered self-concept, feelings of inferiority, depression, shyness and social anxiety.” She added, “We therefore recommend working together with psychologists to extend the indications for therapy of PE to psychological problems. Thus, it is possible to gain information in several dimensions especially attractiveness, self-esteem and social life which affect the patients in all areas of life.”

Habelt, Susanne, Stephanie Korn, Angelika Berger, and Jozef Bielek. “Psychological Distress in Patients with Pectus Excavatum as an Indication for Therapy.” International Journal of Clinical Medicine 2.3 (2011): 295-300. Print.

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Tracy McPherson

    Tracy McPherson

    November 11th, 2011 at 2:01 PM

    My son had PE and never had feelings of low self esteem because as his parent I motivated him to look beyond the physical and into who he is and how he can contribute to society. He had surgery (his decision) last year (2010) not because he looked weird but because his lungs were so big that if he didn’t it would affect his health as he grew (he is now 6′ 5″ at age 19). I believe that children can get beyond their physical limitations or deformities if the parents are mindful of how to motivate the child from another perspective. Great article.

  • maisie j.

    maisie j.

    November 11th, 2011 at 5:49 PM

    Well how about that, someone with a deformity having body image problems. That’s no shock, especially when you’re a teenager and very self-conscious about how you look. I know it’s not the same but I had nasty stretch marks on the back of my legs in high school I was very embarrassed about but eventually I got over it. You need to understand that not everyone judges a book by its cover, and not nearly as many people care about it or even notice it as you yourself think they do. Build your self-esteem up!

  • John


    January 30th, 2017 at 10:47 AM

    @maisie j.: I think we both know there’s a huge fundamental difference between stretch marks on your legs and a deformity on the chest. The chest holds far more value/weight when it comes to body image. Far more. So while i appreciate your attempt at relating to people with chest deformities, i have to add that it was an absolute and utter fail. Stretch marks are nothing compared to a severe case of PC (easily the worst case of chest deformity you can have when it comes to aesthetics). So while you may have gotten over it, realize that your “deformity” wasn’t all that bad in the first place, and it certainly cannot ever be compared to a chest deformity.

  • Rob Sylvester

    Rob Sylvester

    November 11th, 2011 at 6:05 PM

    @maisie j. : That’s what many need to do, get over it. Yes, people will stare at first, but the novelty wears off. If they ask, you can tell them about it. These days in schools, kids with disabilities or deformities have a firewall. Touch them and you get burned ten times worse than if you upset a normal student.

    Report any problems of verbal or physical abuse immediately, kids. Harassment is not tolerated.

  • Harry Gates

    Harry Gates

    November 11th, 2011 at 6:11 PM

    Everyone is shamed one way or another in PE. You can’t all be the top of the class, and not everyone is as physically fit as everyone else. In all honesty I think PE should be optional, not mandatory, since that’s a big cause of self-esteem problems in school. And don’t tell me it improves your health because for all the physical benefits you get, the degree by which it damages your mental health isn’t worth it.

    I remember how horrified I was that you had to change in front of everyone else the first day we had PE. I didn’t even change at home in front of my brother that I shared a bedroom with. And waiting to see if you were picked for teams was a lesson in humiliation too. It’s cruelty, not sport.

  • michael


    November 11th, 2011 at 8:05 PM

    Body image is an integral part of loving who you are. And without a positive image of one’s body there is going to be some trouble. Parents need to recognize this from a very early age and do what they can to encourage their own children to be proud of who they are and the good things that they have to offer.

    It is a great way to reach your children to be strong and confident in who they are.

  • nic


    November 12th, 2011 at 7:29 AM

    kids are cruel even to the perfect looking kids. add something that is a little out of the morm and they have a field day. teach the kids that it is more than about looks. get beyond that to see the real person inside. think of all of the great people in life you are missing out on by always decif=ding to judge a book by its cover.

  • J.N. Holloway

    J.N. Holloway

    November 12th, 2011 at 8:42 PM

    @Harry Gates: “It’s cruelty, not sport.” I’m going to second that!! If you’re making a physically inept student and/or one with a highly-visible deformity humiliate himself in front of his peers, that’s not cool at all. I think coaches have sadistic streaks anyway and enjoy picking on the weaker students as much as the jocks do when the teachers aren’t around to witness it.

    Play ball if you want to, and if not, sit it out and do something more productive and less stressful with that time. That’s how it should be. It’s a win-win for everybody.

  • Rosie


    November 17th, 2011 at 8:03 PM

    Many of you have made very good points about physical education and what children who are different might experience. But, that is not what this article is about. It is about a specific deformity called funnel chest. I have lived with this all my life. I was never made fun of, because I never shared this with anyone. I was very good at hiding it. But this article is about how people with this affliction judge themselves, not how they are judged by others. It is not so easy to “get over” the critical judgements that play in your mind. And this has a big effect on how you perceive yourself. Shame, anxiety and putting yourself down are not simple issues.

  • charlie


    December 17th, 2013 at 1:59 PM

    i was born with funnel chest and am now 31 and have never had it corrected .i would like to type that as a child i had self estem things and most of the things mentioned on this site.most of the affects were psycological with a bit of physcal dysfunction.As an adult though with it though i developed some pretty bad physical reactions to though,they we’re of a differnt nature.they’re kinda hard to discribe ‘they’re like some sort of sycosis or a something i don’t really know of words to describe it but it only showed as an adult.anyway i guess depending on the severty of it.i think that a person could get surgeroy or however to correct it.i thought it would be nice to share my experience.

  • B


    August 8th, 2016 at 10:10 PM

    I first recall my PE developing when I was 9-10. I had a big growth spurt and my chest caved in. Of course kids made fun of it, I was a chubby kid too so I got nicknamed Breastboy. My parents put me in swimming, I remember complaining to my parents but they shrugged it off as me overreacting, I was forced to live with it. I dealt with it and had to get over the social anxiety, self loathing, introversion, embarrassment, insults, people always looking and commenting (especially girls) all through my teenage years. I swam and played water polo in high school and college. I lifted weights and became a good athlete, but always self-concious about my chest. In high school it forced me to have thick skin. Having a brazen disfigurement isnt something you can understand if you don’t have one. I slowly stopped caring, but the not-caring thing spilled into other areas of my life. I had to stop caring about how others thought of me, so I had to stop caring about others all together. I’ve reached points where I stopped caring about myself, or if I hurt others or hurt myself. I did an enlistment in the navy and dealt with it all through that too. It really has hindered my self confidence, particularly with women. Over time I’ve accepted it as best I can, I live a normal life with a job and have been in long term relationships. I’d give anything I ever accomplished or gained in my whole life to go back and have my youth without a caved-in chest. But God is good and life ain’t fair, so F it. I’ve been blessed in many other areas of my life and there are so many people that deal with worse things in their lives. But the moral of the story is: parents-get it fixed for your kids, life is hard enough without a physical deformity. I am now 36, and it still bothers me, I hate taking off my shirt.

  • Anton


    May 8th, 2017 at 7:26 PM

    With all due respect this article (like most) and many of the comments here miss the whole point completely. The low self esteem does NOT come from the pectus sufferer. It comes from the constant, on-going harassment that happens every single time he takes his shirt off. I am over 50 years old and the only change is that as I’ve gotten older the outright comments of, “Your body is disgusting!” have become sneers and aversions of the eyes. Societal response does NOT change over time and no amount of wishful thinking will alter that fact. Parents who do not fix their children’s deformities sentence their children to a life time of rejection and dismissal. It is simply cruel to suggest that any of the suffering a person with pectus goes through is even the slightest bit subjective.

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