Brothers benefit from sunken chest correction surgery: the Nuss procedure

Brothers Evan, far left, and Nolan, second from right, underwent the Nuss procedure to correct sunken chest with Dr. Fizan Abdullah 

When Connie and Brian’s son Nolan complained of chest pain as a young boy, they had a suspicion of what could be causing it: pectus excavatum, or sunken chest.

After all, Brian has a mild form of pectus, meaning his breastbone sinks deeper into his chest than is typical. The condition, which often runs in families and occurs more often in males than females, can come with symptoms such as chest pain and difficulty breathing.

As Nolan grew up and came out of puberty, his condition became much more noticeable, and symptomatic, than his dad’s. He often lost his breath easily when playing sports and felt chest pains at certain times during the day, or when lying down on his side. When Connie noticed on a beach vacation that Nolan’s chest appeared deeply sunken in, she knew it was time to see their pediatrician.

The Lake Villa, Illinois, family’s pediatrician almost immediately recommended the family see a physician with the Chest Wall Deformities Program at Lurie Children’s. There, they met with Dr. Fizan Abdullah, head of the hospital’s division of pediatric surgery and a world-renowned authority on minimally invasive surgery and chest wall deformities, including pectus.

These scans of Nolan's chest before (left) and after (right) surgery shows the marked improvement of his condition, pectus excavatum.

Dr. Abdullah told Nolan, then 17, he qualified for what is known as the Nuss procedure, a minimally invasive surgery that would provide an immediate improvement to the appearance of his chest. After recovery, the surgical correction would likely also help him breathe easier and decrease chest pain.

In the Nuss procedure, Dr. Abdullah implants a stainless-steel bar modified to fit the teen’s chest cavity, which slowly opens up the narrow chest. Nolan would live with the bar in place for two years before having it removed, with immediate improved appearance and function.

Now 21, Nolan looks back on the procedure and says while recovery was at times painful and difficult, “it was worth it.” His experience and great outcome even helped convince his older brother, Evan, to also pursue the surgery.

Dr. Abdullah recognized quickly that Evan, then 24, was also a candidate for the procedure. A runner and basketball player, he often endured difficulty breathing and experienced chest pains when on the court.

evan before and after1.PNG

These scans of Evan's chest before (left) and after (right) surgery shows the marked improvement of his condition, pectus excavatum.

Lucky for Evan, in the years since his younger brother had the procedure, Dr. Abdullah had adopted a new technique to decrease pain and recovery time from the Nuss procedure called cryoablation therapy.

In this technique, Dr. Abdullah and his team during surgery temporarily freeze nerves around the ribs of the patient to minimize pain once the patient wakes up and begins recovery. Evan was among the patients who received the therapy as part of his Nuss procedure, meaning he stayed less time in the hospital following his surgery than his brother and endured less pain during recovery. Typically, those who receive cryoablation therapy stay just one night in the hospital.

Evan had the procedure in November of 2020 and will have the bar removed in 1-2 years. But within two months of getting the bar implanted, he was already back on the court and starting to run 5Ks. “I can do what I want without thinking about it now,” Evan said.

Connie said she and Brian felt Dr. Abdullah’s expertise made all the difference in the care in their sons’ surgeries.

“Everyone at Lurie Children’s has been so kind and helpful,” she said.

Learn more about the Chest Wall Deformities Program, or watch a video of the Nuss procedure (WARNING: there are graphic surgical images present in the video. YouTube may require age verification of 18+ to watch.)

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