Body image in congenital chest wall deformity. Systematic review

Patients with congenital chest wall deformities (CWD) have an obvious impairment in their appearance and therefore often request surgical correction, mostly for cosmetic reasons or for reasons concerning the body image. The latest empirical findings concerning the impairment of body image in patients with pectus excavatum and pectus carinatum are presented. A systematic literature analysis was performed and 21 studies were included in the final evaluation. Patients with a CWD often reported considerable impairment in body image and related aspects, e.g. dissatisfaction with their appearance, hiding of their chest and impaired self-esteem, compared to healthy controls. Impairment in body image is not related to the severity of the deformity but seems to be related to age as younger patients reported less impairment in body image than older patients. Surgical correction often but not consistently leads to improvement in body image. Aspects of body image are highly relevant in chest wall deformities. It is recommended that body image concerns are routinely assessed prior to and following surgical correction and during the course of further interventions. Appropriate instruments can be used for self-assessment of body image by concentrating on chest wall-specific or global aspects of body image.