The terms keel chest or chicken breast refer to a clearly visible prominence of the sternum. Only in rare cases does this lead to physical problems, such as poor posture. Very often, however, a keel breast is a considerable psychological burden for those affected, so that in many cases medical care is necessary.
What is a keel chest?
A keel breast, commonly referred to as a chicken breast, is a deformity of the sternum, which is visibly curved forward. The rib attachments to the sternum may also be bowed forward. The main problem with the presence of a chicken breast is not medical but psychological. Only rarely does a chicken breast cause physical discomfort, but it often leads to psychological problems, such as a lack of self-confidence. The psychological burden is not infrequently considerable, especially during puberty, and often requires medical attention. Due to the keel breast, there may be poor posture and incorrect movement patterns, which require physiotherapeutic care. A keel-shaped protrusion of the sternum occurs more often in boys or men than in women.
Causes
Only in exceptional cases is a child born with a keel breast. Typically, it develops from or after the age of ten. The exact causes for the development of a keel chest are still unclear. It is assumed that the affected person has an excessive curvature of the sternum because cartilage that is located on the ribs grows too much and forces the sternum to curve forward. Exactly what causes the excessive growth of cartilage remains to be determined. However, a certain genetic predisposition is likely to play a role. For example, doctors have observed that there can be a clustering of breast deformities within families. The probability of developing a wedge breast is therefore increased if there are already such cases in the family.
Symptoms, complaints and signs
A keel chest is first noticeable by the characteristic bulging of the sternum. The bone protrudes forward conspicuously, while the upper part of the breast may be flattened. This malformation causes accompanying symptoms such as shortness of breath and chest pain. Rarely, severe deformities develop that require independent treatment. Affected individuals also frequently complain of impaired lung function, which not only makes breathing difficult, but also reduces physical and mental performance as a result of oxygen deficiency. Sufferers have to take regular breaks from breathing and are usually no longer able to engage in sporting activities. Finally, a keel chest can lead to poor posture. Many sufferers are ashamed of the deformity and try to conceal it with a stretched posture. Among other things, this can lead to back pain. In children, a pronounced keel chest can hinder growth. A chronic lack of oxygen supply to the organs often results in further diseases and disorders. These represent a great burden for the affected person and subsequently cause psychological discomfort. The keel chest usually develops after the age of ten, usually beginning with puberty. Congenital deformity is relatively rare.
Diagnosis and course
The diagnosis of a keel breast is made by looking closely at the patient; this is then called a gaze diagnosis. The deviation from the norm can be seen directly by the physician without further examination. Often, an x-ray is also taken to establish the diagnosis. This allows the treating physician to take a closer look at the excessive curvature of the sternum and the cartilage growth defect on the ribs. The X-ray image secures the visual diagnosis. Basically, a keel breast is not a disease, as it usually progresses without physical symptoms. In some cases, pain may occur in the chest area. Sleeping on the stomach is also sometimes experienced as unpleasant. Only in exceptional cases, where there is a severe deformation of the sternum, does pulmonary function become restricted. Affected persons then quickly get out of breath and have to take more breathing breaks than usual during physical activities.
Complications
In most cases, keel chest does not result in any particular physical limitations or restrictions on the patient’s health.However, the keel chest can have a very negative impact on the psyche of the affected person, causing discomfort. As a rule, the sternum is curved forward in this disease, which leads to a greatly reduced aesthetic appearance of the patient. It is not uncommon for this to cause the patient to have reduced self-esteem or even inferiority complexes. Depression or other psychological stress can also occur as a result of this condition. Furthermore, the keel chest can lead to breathing difficulties, so that the affected person suffers from an increased respiratory frequency. The patient’s ability to cope with stress also decreases as a result, and certain activities may no longer be possible. Sporting activities may also be restricted in the patient. Treatment of the keel chest is only carried out if there are actual complaints. Parts of the ribs and the sternum can be removed so that the complaints are reduced. Psychological treatment is often necessary if, for example, teasing or bullying occurs. There are usually no further complications in this process.
When should you go to the doctor?
From a medical point of view, keel chest is not a cause for concern in most cases. The physical functions of the individual systems of the organism are not affected by the protrusion of the chest. A shortening of the life span or disturbances of the cardiac activity are also not given by the deformity. For a diagnosis and a thorough control examination, a doctor should be consulted at the first signs of the development of a chicken breast. Normally, no further doctor’s visit is necessary afterwards due to the chicken breast. The exception is patients who suffer from other malformations of the skeletal system in addition to the keel breast. If the patient suffers from lopsided posture, one-sided strain or musculoskeletal complaints, a doctor should be consulted. In case of persistent or regularly recurring tension as well as a feeling of stiffness, a doctor should be consulted. A general feeling of malaise, behavioral abnormalities or changes in personality are indications that the affected person needs help. If emotional and mental problems occur, a visit to the doctor is advisable. Sleep disturbances, an inner restlessness, interruptions in the ability to concentrate, mood swings or a depressive demeanor are more advanced complaints that should be discussed with a therapist. Support and help are needed for a decreased sense of well-being, social withdrawal, partnership as well as attachment problems, feelings of anxiety or shame.
Treatment and therapy
Since a keel breast usually does not cause any health complaints, it does not necessarily need to be treated. If the patient does not feel subjectively restricted, then there is no reason for any therapies, as a wedge breast is medically harmless. If a patient suffers from the deformity of his breast and develops self-esteem problems, psychological or psychotherapeutic help should be offered. Psychotherapeutic care is especially helpful for patients in whom the wedge breast is not very pronounced and therefore surgery is not recommended due to the risks involved. In children who are still growing, therapy with a pad, i.e. a bandage, can be very promising and can replace surgery. Such a procedure is lengthy and often unpleasant and only promising if the affected person is motivated. If the sternum is severely deformed, this can also lead to health problems such as shortness of breath. In addition, those affected very often suffer from their appearance. Children and adolescents with a keel chest in particular are often teased, which further affects their already battered self-confidence. In such cases, surgery is recommended. During the operation, parts of the sternum and the ribs are removed. After the surgery, further treatment is needed to be able to improve lung function.
Outlook and prognosis
The prognosis of a keel breast is favorable. Normally, there are no adverse health effects despite the protrusion of the chest. Therefore, it is an optical blemish, which in most cases has no disease value. Often, for this reason, no further treatment of the patient takes place.The lifespan is not shortened and physical secondary diseases are unlikely due to the keel breast. The prognosis worsens if emotional and mental problems occur due to the visual abnormalities. These may contribute to the development and formation of a mental disorder. Therefore, well-being and psychological stability must be taken into account when making the overall prognosis. If a mental illness is present, it can have a significant impact on the health of the person affected. In addition to behavioral abnormalities, changes in personality as well as a deteriorated quality of life, anxiety disorders or attachment problems may occur. In rare cases, keel chest leads to respiratory distress or impaired breathing. If the patient decides to undergo surgery due to the physical limitations or emotional stress, the appearance of the chest can be significantly altered and thus optimized. As a rule, no further complications occur during the operation. Nevertheless, every intervention as well as a change in the human physique is associated with risks and side effects.
Prevention
There are no promising measures for the prevention of a keel breast, since it is not yet clear what the actual cause of the excessive growth of the rib cartilage is.
Follow-up
The extent to which follow-up care is necessary depends on the therapeutic measure chosen and the individual’s sense of discomfort. In the best case, there is only an optical blemish that does not lead to any physical suffering. In this case, follow-up care may not be indicated. The patient continues with his or her life after receiving the diagnosis. The situation is different if the keel breast causes mental suffering. Then psychotherapy is necessary. In most cases it leads to an increase in self-confidence and can sometimes take place several times. Only in rare cases is surgery advised. This treatment leads to the expectation that after some time patients will go on with their lives completely free of complaints. The keel breast has then disappeared. A recurrence is just as impossible as everyday complaints. However, months or years may pass before this happens. Immediately after surgery, aftercare consists of respiratory and physiotherapy. Stabilization of the body is achieved by means of a pressure pad bandage. Furthermore, the improvement of mobility and strengthening of the musculature play an important role. Follow-up care is usually performed on an outpatient basis. To assess the success of the therapy, the treating physician arranges for X-rays to be taken. Scheduled follow-up examinations usually take place at increasingly longer intervals. They end as soon as the desired result has been achieved.
What you can do yourself
Depending on its severity, a keel breast can cause self-esteem problems and other emotional distress. Affected individuals can counteract this by being open about the deformity and learning to stand by their body. Psychological or psychotherapeutic help supports this process and is particularly helpful for patients for whom surgery is not an option. Other measures are limited to concealing the keel breast. In most cases, a little more clothing and a conscious adjustment of posture are sufficient for this. If the keel chest has already caused a visible malposition, this requires [physiotherapy|physiotherapeutic treatment]]. Conscious walking and exercises from yoga or physiotherapy are ways to correct the bad posture at home or on the road. However, it usually takes months or even years for the posture to return to normal. In addition, drug therapy is always necessary, since poor posture is usually associated with pain. The keel chest itself can only be corrected in the long term by surgery. Affected persons who wish to have the condition treated surgically should seek a medical examination at an early stage and arrange for the necessary steps to be taken.
