While objective improvement in cardiopulmonary status has been difficult to prove consistently following operative repair, the majority of patients with pectus excavatum report significant postoperative improvement in exercise tolerance. Chest cosmesis is the most frequent reason for evaluation of a patient with pectus excavatum.3The psychological stress associated with pectus excavatum can be an indication for repair even in the absence of objective cardiopulmonary compromise.4 In operative repair, a midline sternal incision is made, then the sternal perichondrium is elevated to expose the deformed cartilages. A complete subperichondrial resection of all deformed cartilages is performed. A transverse sternal osteotomy is performed, the posterior cortex of the sternum is fractured, and the sternum is mobilized anteriorly and fixed in place with nonabsorbable suture in a slightly overcorrected position.5In older patients, internal fixation with a Steinmann pin is used to support the sternum in the corrected position, and the pin is removed under local anesthesia in 6 months. The pectoral and rectus muscles are closed over the sternum, and the skin edges are reapproximated.