ArticleJPRAS open2026
The hidden mechanism of vacuum bell therapy: Local fat hypertrophy drives cosmetic outcome in adolescents with pectus excavatum.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Purpose: Vacuum bell (VB) therapy is a non-invasive treatment option for pectus excavatum (PE), traditionally considered most effective in children under 12 due to greater skeletal remodeling potential. However, the extent and mechanisms of cosmetic improvement in older adolescents remain poorly understood. Methods: We retrospectively analyzed 19 male patients (median age 14.8 years) who underwent VB therapy for at least 1 year. Real-time MRI was performed before and after therapy to assess morphological changes. Key parameters included the Haller Index (HI), Correction Index (CI), and pectus excavation depth (PED). Additionally subcutaneous soft tissue thickness was measured at the deformity site and at the lateral thoracic wall. Results: After a median treatment duration of 1.8 years, HI and CI did not show significant reductions (HI: 5.4 to 5.3, Conclusions: The improvement in visual appearance of PE morphology during VB therapy results primarily from localized adipose tissue hypertrophy, while skeletal remodeling is likely to contribute to a much lesser degree. From a cosmetic perspective, these findings might justify the continued use of VB therapy beyond the traditional age threshold.
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