Pectus excavatum, sometimes called a “sunken chest,” is a condition where the breastbone sinks inward, giving the front of the chest a caved-in look. Many children live healthy, active lives with this condition, but for some, the appearance or depth of the chest can cause physical or emotional concerns. The vacuum bell device offers a non-surgical way to gently lift the breastbone over time using controlled suction.
This article explains what the vacuum bell is, how it works, when it may be recommended, and what families can expect during treatment so parents can make informed decisions with their child’s care team.
What Is Pectus Excavatum?
Pectus excavatum is a chest wall difference where the breastbone (sternum) and some of the nearby ribs grow inward instead of outward. This creates a dip or hollow in the middle of the chest that can look mild in some kids and quite deep in others.
- The condition is usually present at birth or becomes more noticeable during growth spurts in late childhood and adolescence.
- Many children have no medical symptoms, while others may experience shortness of breath, reduced exercise stamina, or occasional chest discomfort, especially as they get older.
What Is the Vacuum Bell Device?
The vacuum bell is a dome-shaped device made from soft, flexible material designed to sit over the front of the chest. It connects to a small hand pump that removes some of the air from inside the dome, creating a gentle vacuum (negative pressure) that pulls the breastbone forward.
- The device comes in different sizes to fit children, teens, and sometimes adults with various chest shapes.
- Medical providers customize the fit and give detailed instructions so the device rests firmly but comfortably against the skin.
How the Vacuum Bell Works
The vacuum bell does not change the bones all at once. Instead, it applies repeated, gentle traction over many months. Each time the vacuum is created, the breastbone lifts slightly. Over time, the chest wall tissues can adapt to this new position, and the inward curve may become less noticeable.
- During each use, negative pressure is created gradually so the child can adjust to the pulling sensation.
- With consistent use, the breastbone may start to sit higher, even when the device is not on, especially in younger patients whose bones are still flexible.
Who Might Benefit From Vacuum Bell Therapy?
Vacuum bell treatment is usually considered for children and teens who have a visible sunken chest but either do not need or do not want surgery. It is often more effective earlier in life, while the chest wall is still growing and more easily reshaped.
- Common candidates include kids with mild to moderate pectus excavatum and good skin tolerance over the breastbone.
- Families who prefer a non-surgical route, or who want to see if improvement is possible before considering an operation, may be especially interested in this device.
Who Is Not a Good Candidate?
Vacuum bell therapy is not right for everyone. Some underlying health conditions can make the suction unsafe or less effective. Before starting, the care team will review the child’s medical history and may order tests to check heart and lung function.
- Children with certain bone, blood vessel, or bleeding disorders may be advised against using the device.
- Very severe, rigid, or asymmetric chest shapes may not respond well and might be better treated with surgical methods.
Getting Started: The Evaluation Visit
Before a vacuum bell is prescribed, the child usually has a detailed evaluation with a pediatric surgeon or chest wall specialist. This visit helps determine if vacuum therapy is a safe and realistic option.
- The provider examines the chest, measures the depth of the sunken area, and may review imaging or breathing tests if they are available.
- Families can ask questions about the device, understand expected commitment, and discuss alternatives such as watchful waiting or surgery.
How the Device Is Fitted
Once the child is approved for treatment, the care team selects a device size and shape that best matches the chest. A fitting visit allows the child to practice using the vacuum bell under supervision and to learn how it should feel.
- The device is placed over the center of the chest while the child lies comfortably on their back so the dome sits evenly against the skin.
- The pump is used to remove air slowly until the child and provider see the chest lifting gently without pain or significant discomfort.
Typical Daily Routine With the Vacuum Bell
Most treatment plans involve using the device every day over an extended period. Consistency is more important than using it for very long sessions once in a while. The provider will tailor the schedule to the child’s age, chest shape, and tolerance.
- Early on, the device may be worn for short sessions, such as 15 to 30 minutes once or twice a day, to allow the skin and muscles to adapt.
- As the child gets used to the sensation, the provider may increase the daily duration, sometimes to several hours spread throughout the day, if tolerated and recommended.
Step-by-Step: Using the Vacuum Bell at Home
Although each clinic may give slightly different instructions, most families follow a similar sequence each time the device is used. Clear, consistent steps help keep treatment safe and effective.
- Prepare the skin. The chest area should be clean, dry, and free of lotions that might break the seal or irritate the skin.
- Position the device. While lying down, the child (or parent) centers the dome over the sunken area, making sure the rim touches the skin evenly all around.
- Create suction slowly. Using the hand pump, air is removed in small steps. The child should feel a firm pull but not sharp pain.
- Check comfort. After a short time, the child can sit or stand up carefully, making sure the device stays in place and feels secure.
- Complete the session. At the end of the planned time, the valve is opened or the pump is released to let air back in, and the device is lifted away gently.
What Does Treatment Feel Like?
Most children describe a pulling or pressure sensation across the chest while the device is in place. Mild discomfort in the first few days of use is common but often improves as the body adjusts to the new routine.
- The skin under the rim of the device may become pink or slightly marked temporarily due to suction, similar to a firm cup pressed against the skin.
- If the child feels sharp pain, dizziness, or difficulty breathing, treatment should be stopped and the care team contacted for advice.
Possible Side Effects and Risks
Vacuum bell therapy is generally considered a low-risk, non-invasive treatment, but no therapy is entirely free of side effects. Most issues are mild, short-lived, and improve with adjustments in suction strength or session length.
- Common minor side effects include temporary skin redness, mild soreness, or small bruises where the device rim presses on the chest.
- Less commonly, children may notice tingling, temporary changes in skin color, or a feeling of tightness in the chest, which should be reported to the provider.
Monitoring Progress Over Time
Follow-up visits allow the care team to track how the chest shape changes and whether the current plan should continue or be adjusted. These visits are also a chance to address challenges with daily use and to support the family’s efforts.
- Providers may measure the depth of the sunken area at each visit, using the same method each time to see subtle improvements.
- Photographs taken several months apart, with the child in the same position, can help families see gradual changes that might be hard to notice day-to-day.
How Long Does Treatment Take?
Vacuum bell therapy is a commitment that usually spans many months or even a few years. The length of time depends on the child’s age, degree of chest depression, and how consistently the device is used.
- Some children show visible changes within the first few months, while others progress more slowly.
- Even after good improvement is seen, providers may recommend continued use for a period to help maintain the new chest position.
Vacuum Bell vs. Surgical Treatment
Both the vacuum bell and surgical procedures aim to improve the shape of the chest, but they differ in how quickly results occur, how invasive they are, and what risks they carry. The best approach depends on the individual child’s anatomy, symptoms, and family preferences.
| Aspect | Vacuum Bell Therapy | Surgical Correction |
|---|---|---|
| Invasiveness | Non-surgical; performed at home with a removable device. | Involves an operation under anesthesia with incisions. |
| Speed of Results | Gradual change over months to years. | Visible chest shape change soon after surgery. |
| Ideal Candidates | Mild to moderate, flexible chest walls; motivated families. | Moderate to severe deformities, rigid chest walls, or when non-surgical methods are not effective. |
| Risks | Mostly minor skin and soft tissue side effects, usually temporary. | Higher medical risk due to anesthesia, pain, and potential surgical complications. |
| Daily Lifestyle Impact | Requires consistent use and time each day but no hospital stay. | Requires hospital care, recovery time, and activity limits after surgery. |
Helping Your Child Stay Consistent
Because results depend heavily on regular use, family support plays a major role in the success of vacuum bell treatment. Turning the therapy into part of a daily routine can help children stay engaged and positive.
- Some families link use of the device to predictable times of day, such as after homework or before bedtime, so it becomes a habit rather than an occasional task.
- Setting realistic goals, celebrating small milestones, and staying in close contact with the care team can all keep motivation high.
Emotional and Social Considerations
Pectus excavatum can affect how children feel about their appearance, especially during the preteen and teenage years when body image becomes more important. Treatment decisions are often about confidence as much as about physical symptoms.
- Some children feel more comfortable wearing certain clothing or avoiding activities like swimming; discussing these feelings openly can help.
- Counseling, peer support, or connecting with other families facing similar decisions may provide reassurance during the treatment journey.
Talking With Your Child’s Care Team
Choosing vacuum bell treatment is a shared decision between the family and the medical team. No single plan is right for every child, and questions are welcome at any step.
- Parents may want to ask about expected improvement, ideal duration of treatment, and how to recognize when the chest has stabilized.
- It is also important to know what signs should prompt a break from treatment or an earlier follow-up visit.
Frequently Asked Questions (FAQs)
1. Is the vacuum bell painful?
Most children feel a strong pulling or tightness at first, but not sharp pain. Mild soreness is common in the first few days or after increasing treatment time. If pain becomes severe or does not improve with adjustments, families should contact the care team for guidance.
2. Can my child play sports while using the vacuum bell?
Children usually remove the device during physical activity to protect both the chest and the device. In many cases, kids can continue with their usual sports and play when the device is not on, but families should follow activity instructions given by the child’s provider.
3. Will the improvements last after we stop using the device?
When vacuum bell therapy is successful, the breastbone may stay in a higher position even when the device is no longer used regularly. To help maintain the changes, providers may recommend tapering off gradually rather than stopping all at once, and continuing follow-up visits during and after treatment.
4. At what age is the vacuum bell most effective?
The device tends to work best in children and younger teens whose bones and cartilage are still relatively flexible. However, older adolescents and some adults may also benefit, depending on chest shape and overall health, which is why an individualized evaluation is essential.
5. Does insurance cover vacuum bell treatment?
Coverage for vacuum bell devices varies. Some plans may consider it a medical treatment and help pay for the device, while others may classify it differently. Families are encouraged to talk with both their care team and their insurance provider before starting treatment to understand potential costs.
Key Takeaways for Families
- The vacuum bell offers a non-surgical, home-based option to gradually lift a sunken chest in selected children and teens.
- Successful treatment depends on choosing appropriate candidates, using the device as directed, and maintaining close follow-up with the medical team.
- Parents and children should feel comfortable asking questions, discussing concerns, and revisiting treatment decisions as the child grows and their goals evolve.
