Pectacular – Comprehensive, Patient-Centered Care for Chest Wall Deformities

At University Surgical Associates (USA), we are proud to offer Pectacular!, a multidisciplinary Chest Wall Reconstruction Program designed to provide individualized care for patients of all ages with chest wall deformities. Led by Dr. Lisa A. Smith, a board-certified pediatric surgeon with over two decades of experience, our program addresses conditions such as pectus excavatum, pectus carinatum, pectus arcuatum, and other complex chest wall anomalies.

About Dr. Lisa A. Smith

Dr. Smith has been in practice since 2001 and has dedicated her career to the surgical care of children.  With the success of her pediatric chest wall reconstruction program, she has expanded her scope and now treats both children and adults with chest wall deformities. She has evaluated thousands of patients and performed more than 400 chest wall reconstruction surgeries.

Dr. Smith serves as the Medical Director for both the Pediatric Chest Wall Reconstruction Program at Children’s Hospital at Erlanger and the Adult Chest Wall Reconstruction Program at Parkridge Medical Center. Her commitment to excellence and patient-centered care has made her a leader in the field.

Understanding Chest Wall Deformities

Chest wall deformities involve abnormal development or structure of the chest wall, which can impact both appearance and physiological function. Common conditions include:

  • Pectus Excavatum: A sunken or caved-in appearance of the chest, which can compress the heart and lungs, leading to reduced cardiac and pulmonary function.

  • Pectus Carinatum: An outward protrusion of the chest wall, often referred to as “pigeon chest,” which can cause restriction of chest wall motion, discomfort, and self-consciousness.

  • Pectus Arcuatum: A rare deformity characterized by a curved or arching chest wall with an S-shaped sternum.  It has characteristics of both excavatum and carinatum.

These conditions are not merely cosmetic; they can have significant impacts on cardiopulmonary physiology, posture, and overall quality of life.

Our Multidisciplinary Approach

The Pectacular! program emphasizes a comprehensive, team-based approach to care, involving:

Consultation: Each patient’s journey begins with a thorough consultation. Dr. Smith takes a detailed medical history, performs a comprehensive physical exam, and discusses the findings clearly with patients and families. When appropriate, she orders additional tests—such as imaging or pulmonary function studies—to fully understand the impact of the deformity. Patients are often connected with additional specialists, such as cardiologists, pulmonologists, or geneticists, to screen for associated conditions and ensure a complete, coordinated plan of care. Families also receive guidance and resources tailored to their needs, helping them feel supported and informed at every step.

If surgery is recommended:

  • Preoperative Education: Informative sessions to prepare patients and families for the treatment journey.
  • Prehabilitation (“Pre-hab”): Exercises and breathing techniques to strengthen the chest wall before surgery.
  • Surgical Intervention: Minimally invasive procedures like the Nuss Procedure for pectus excavatum and the highly-modified Ravitch procedure for pectus carinatum and arcuatum.
  • Postoperative Care: Ongoing support, including pain management and physical therapy, to ensure a smooth recovery.

Our team includes surgeons, anesthesiologists, nurses, physical therapists, and support staff, all dedicated to providing the highest level of care.

If a non-operative approach is recommended:

  • For many patients with pectus carinatum, non-operative bracing is an effective treatment. Approximately 85% of these patients achieve significant improvement with custom-fitted braces, avoiding the need for surgery. Our bracing program is tailored for children and adolescents, ensuring optimal outcomes.
  • For patients with mild pectus excavatum, a nonoperative approach can be highly effective and includes targeted physical therapy to strengthen the chest wall and improve respiratory mechanics. This strategy also focuses on correcting secondary musculoskeletal changes—such as rounded shoulders and scapular winging—to enhance overall function and appearance.

Women’s Health Initiative

Recognizing that chest wall deformities in women are often underdiagnosed, we have launched a Women’s Health Initiative and community outreach program aimed at identifying and treating these conditions. This program focuses on the unique presentation and needs of adult women with chest wall anomalies, providing specialized care and support.

Benefits of Treatment

Correcting chest wall deformities can lead to:

  • Improved posture and chest wall motion

  • Enhanced cardiac and pulmonary function

  • Increased exercise tolerance

  • Boosted self-confidence and quality of life

Dr. Smith emphasizes that these conditions are not merely cosmetic concerns but can have significant physiological impacts. Proper treatment can lead to transformative results for patients.

Patient Testimonials

Our patients and their families have expressed profound gratitude for the care received through the Pectacular! program. Here’s just one example.

Their experiences highlight the positive outcomes and trust placed in our team’s expertise.

Schedule a Consultation

If you or your child is experiencing a chest wall deformity, we invite you to schedule a consultation to explore treatment options.

Clinical Support and Contact Information:

Kandace Pryor, Dr. Smith’s nurse of more than 15 years, is an invaluable part of our chest wall reconstruction team. She manages both office and surgical scheduling with precision and care, ensuring a seamless experience for patients and families. Kandace is incredibly knowledgeable about chest wall deformities and their treatment, and she’s often the first person families turn to with questions—always ready with clear, compassionate answers. Her experience and dedication are central to the exceptional care we provide.

  • Phone: (423) 267-0466

  • Fax for Referrals: (423) 778-5177

  • Location: USA Medical Mall, Downtown Chattanooga

For more information about Dr. Lisa Smith and the Pectacular! program, please visit our website or contact our office directly.