It all started with a photo. Caden, 8, was acting "goofy" in the family's kitchen when his mom Stacy Woelber grabbed her camera but noticed a small indentation on his chest. As he got older and grew taller, the indentation deepened and Caden grew more self-conscious - hunching over, swimming with his shirt on and wearing hoodies, even in the summer.
Dr. Sid Dassinger diagnosed Caden at 13 with pectus excavatum, the most common of two chest wall deformities where the “breastbone grows in and sinks,” Dassinger explained. The other, pectus carinatum, is where the breastbone grows out, nicknamed “pigeon chest.”
"They tend to get deeper during periods of rapid growth in and around puberty," Dassinger explained of pectus excavatum. "There has been a little bit of a label as a cosmetic operation. However, having done it on enough kids now, they almost all will tell you their breathing has improved. The other component of it is self-image. There have been studies that have shown documented improvement in self-image after the procedure is performed. So, I really don't view the procedure as cosmetic."
Even though the surgery meant Caden would give up playing baseball in the summer and possibly the fall, Stacey said her son had no hesitation.
“I want it done as quickly as possible,” Caden told his parents.
The Nuss procedure, a minimally invasive surgery, involves two small incisions on both sides of the chest. A curved bar is placed behind the breastbone to lift it and correct the defect. It is removed after three years.
Stacy said everything, including the staff, was great at Arkansas Children’s Hospital.
"Dr. Dassinger has such a great bedside manner. He kept us updated every bit of the way, finding out what was going on, how the surgery went. They did an excellent job assuring us that everything was fine," she said.
Patients typically have a two-day post-operative stay after the Nuss procedure. They're typically seen two or three times during the first year, and then once a year until the bar is removed.
Caden built up confidence and resumed a “completely normal life” 18 months after the life-changing surgery.
"When he gets done in another 18 months and has the bar removed, he should never have any problems with it and he can do exactly what he wants to do," his mother said. "He is thrilled with the results. He stands up straight now, walks proud and has far more confidence than he ever had."
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The General Surgery Clinic at Arkansas Children's provides surgical care for hernias, chest wall deformities, and other conditions.
Pectus excavatum or sunken chest is one of the most common chest wall disorders in children.
The Nuss Procedure is a minimally invasive technique used by pediatric surgeons at Arkansas Children's to correct pectus excavatum (sunken chest).