Does the Pectus Excavatum Vacuum Bell Really Work? Here’s What the Evidence Shows

A Mother’s Message

We often receive messages like this one in our inbox:

“Doctor, I bought a Pectus Excavatum vacuum bell online. My child has been using it for three months, and I think I see some improvement… but I’m not sure. Should we continue?”

This message came from the mother of an 8‑year‑old. Her words carried both hope and uncertainty.

We encounter similar questions almost every week. Parents search online for “non‑surgical treatment for Pectus Excavatum” and find ads for various vacuum bells and braces. Prices range from a few dollars to several hundred. In the comment sections, some say, “After six months, the sternum has visibly lifted,” while others write, “A year of use and no change.”

Whose experience should you trust?

Today, we’ll take a careful look at this question: Does the Pectus Excavatum Vacuum Bell actually work?

1. First, Understand How Pectus Excavatum Develops

To evaluate any treatment, you first need to understand the condition itself.

Pectus excavatum is a chest wall deformity in which the sternum and costal cartilages sink inward, creating a “funnel‑shaped” depression. It is the most common congenital chest wall deformity in children, affecting approximately 1 in 400 to 1,000 children.

Why Does the Chest Cave In?

Current medical understanding suggests that the core issue lies in overgrowth of the costal cartilages—they grow faster than the sternum, pushing the sternum inward. This is a structural problem, not weak muscles or poor posture.

How Is Severity Measured?

Clinically, the Haller Index is used to assess severity:

The higher the Haller Index, the deeper the depression and the greater the potential cardiopulmonary impact.

2. How Does the Vacuum Bell Work?

The vacuum bell (sometimes called a negative pressure correction device) is a non‑surgical device used for pectus excavatum.

Its mechanism is straightforward:

• A silicone or plastic cup is placed over the depressed area.

• Air is removed manually or with a pump to create negative pressure.

• Atmospheric pressure then pushes the chest wall outward, lifting the depression.

The idea is intuitive—similar to using a suction cup to pull out a dent in a car door.

This approach was developed and promoted by German physician Dr. Eckart Klobe around 2009. It has been used clinically in Europe under the brand name “Vacuum Bell.”

3. What Does the Evidence Say? A Science‑Based Look

This is the question parents care about most. Let’s review the existing evidence.

✅ Evidence That Supports Use

Most published studies on the vacuum bell come from observational research in European centers:

• Haecker et al. (2011) followed 220 patients. Approximately 70% showed some degree of sternal elevation after use; about 20% achieved “complete correction” (mostly those with mild deformities).

• Characteristics of responders: Younger age (more flexible skeleton), shallower depression (lower Haller Index), and symmetric depression were associated with better outcomes.

• Treatment duration: Meaningful change typically requires 1–2 hours of daily use for 1–3 years.

❌ Important Limitations

Equally important are the limitations that must be acknowledged:

1. Results vary significantly between individuals.
   After a year of use, some children show clear improvement while others see little change. Currently, no reliable method can predict who will respond well.

2. Limited effectiveness in severe cases.
   For patients with a Haller Index > 3.5, the vacuum bell alone rarely achieves satisfactory correction. These patients also need to be evaluated for cardiopulmonary effects.

3. Quality of products on the market varies widely.
   Prices range from tens to thousands of dollars. Some products have poor pressure control, and prolonged use can cause skin damage, bruising, or even rib deformation.

4. Frequently Asked Questions (FAQ)

Q1: At what age is a child suitable for vacuum bell therapy?

A: Generally, children between 3 and 12 years have more flexible chest walls and may be good candidates for conservative treatment. After puberty, as the skeleton stiffens, effectiveness decreases. A physician should evaluate the Haller Index and depression type before deciding.

Q2: If my child uses a vacuum bell, will surgery still be needed?

A: It depends. For children with mild to moderate, symmetric pectus excavatum, a trial of conservative treatment may be reasonable. However, if there is evidence of cardiopulmonary impairment (such as reduced exercise tolerance or cardiac compression), the Haller Index > 3.5, or conservative treatment fails, surgery remains a more reliable option.

Q3: How long does daily use require? Will it affect daily life?

A: Typically, 1–2 hours per day, often divided into sessions during quiet activities like watching TV or before bed. The child must remain relatively still during use, which can be challenging for active children.

Q4: What’s the difference between a vacuum bell bought online and one used in a hospital?

A: The difference can be significant. Properly qualified devices have clearly defined pressure control (usually not exceeding -150 mbar), safe materials, and available size options. Low‑cost products often lack these safeguards. We recommend choosing a device with proper certification and having regular follow‑up evaluations.

Q5: My child’s skin becomes red or bruised after use. Is this normal?

A: Mild redness that fades within hours is common. However, if you see significant bruising, subcutaneous bleeding, or skin breakdown, the pressure is too high or the session too long. Stop use immediately and consult a physician.

5. What Should Parents Do?

If you are considering the vacuum bell for your child, here is a step‑by‑step approach:

Step 1: Get a Professional Evaluation First

Do not buy a device based solely on online advertisements. Take your child to a pediatric or thoracic surgeon for a thorough assessment, including:

• Chest CT to measure the Haller Index

• Echocardiogram (to check for cardiac compression)

• Pulmonary function tests (if indicated)

Only with a clear understanding of your child’s specific condition can you make an informed decision.

Step 2: If You Decide to Try It, Choose a Qualified Product

• Prioritize devices with medical device certification

• Work with your physician to determine the appropriate size and pressure range

• Avoid inexpensive, unverified products

Step 3: Follow Up Regularly

Conservative treatment is not “buy it and use it at home indefinitely.” A follow‑up schedule is essential:

Step 4: Keep Realistic Expectations

The vacuum bell is neither a miracle device nor a scam. It is a conservative treatment with a scientific basis—appropriate for a specific group of patients, requiring long‑term commitment, with results that vary individually.

For children with mild to moderate pectus excavatum, it is worth trying under medical supervision. But if the deformity is severe, or if after a reasonable trial there is little improvement, do not let “fear of giving up” delay the option of surgery when it is needed.

6. Final Thoughts

Every parent who comes for advice carries the same thing in their eyes: hope.

Hope that surgery can be avoided. Hope that their child will suffer less. Hope that a vacuum bell will slowly lift the sunken sternum.

We understand this completely.

As a non‑surgical option, the vacuum bell does offer another possibility for some children and families. But medical honesty requires us to tell you: it does not work for everyone. It takes time and commitment. It has limitations.

Making a truly informed decision means understanding both what the vacuum bell can do and what it cannot. Only then can you choose the path that is right for your child.

Disclaimer: This article is for educational purposes only and does not constitute medical advice. Treatment decisions should be based on a thorough evaluation by a qualified healthcare professional. If you have concerns about your child’s chest wall, please consult a specialist.