A vacuum bell is a cup or bowl-shaped device, made of orthopedic silicone.
It is connected to a pump. It should be placed directly on the dent in your chest. For best results, it should be sized to fit each patient perfectly.
The purpose of the pump is to suck the air out of the device. This creates a vacuum or suction that pulls the sternum in a normal position.
It needs to be applied daily.
After a certain period of constant device use, the breastbone will get back to a corrected position on its own.
Nowadays, it is considered as an excellent alternative to surgery.
Patients with mild pectus excavatum are the ideal candidates for vacuum bell therapy, especially if they want to evade surgical procedures.
The vacuum bell causes small cracks (microfractures) in the sternum. New bone material will form in the fracture gaps to stabilize the "new" breast form.
However, it is safe and straightforward to use.
Most of the research on the effectiveness of the vacuum bell therapy for pectus excavatum comes in a study done in Switzerland. The study included 140 patients (112 males and 28 females).
In this study, the patients averaged around 100 minutes of vacuum bell application a day. The therapy was finished after 20.5 months.
In 61 patients, the breastbone was raised to a normal level after 21.8 months of therapy.
To conclude, about 80 percent of all the patients saw a tremendous improvement in their chest wall, and about 15 percent of them got a total repair. Couple patients had only applied the suction cup device for nearly a month.
There is a definite chance that they could’ve had fantastic improvement if they continued to follow the therapy.
The successful results in the study are the exact reason why doctors worldwide feel comfortable doing the vacuum bell treatment on patients.
CT scan images of the Pediatric Surgical Clinic of the University of Jena in Germany, show an immediate lifting of the sunken chest after a vacuum bell therapy.
The images above show the effectiveness of the Eckart Klobe vacuum bell in the very first day of therapy.
The before and after images are done only a few minutes apart.
This is the very first CT scan image done on a patient who started the vacuum bell therapy.
In the Before photo, you can see a noticeable dent in the sternum.
In the second photo, you can see how effective the vacuum bell device is in lifting the sunken chest to a normal position.
Again, you can also see an amazing improvement in the raising of the indented chest.
This proves how effective the vacuum bell therapy is in correcting the pectus excavatum deformity.
Dr. Corey Iqbal, is a general surgeon in Overland Park, Kansas. He is allied with Overland Park Regional Medical Center. He did postgraduate training at the Mayo Clinic and had a track record of trying innovative things.
Dr. Corey received his medical degree from the University of Missouri - Kansas City School of Medicine.
Here is what he had to say about the vacuum bell therapy for pectus excavatum in a recent 2019 interview, for the Kansas City's largest, award-winning healthcare network.
In addition, he said the following:
“The risks of a vacuum bell therapy are minimal, while the benefits are potentially significant.”
Dr. Corey Iqbal
You can read the full interview about why he is such a huge fan of the vacuum bell therapy for pectus excavatum here.
Also, lots of other surgeons started implementing the suction bell therapy.
Dr. Robert J. Obermeyer is the leader of the non-surgical correction of the inverted chest at CHKD, the nation's best exploration facility for chest-wall abnormalities and a teaching site for doctors from around the world.
“Years from now, we may look at the surgical procedures and realize that many of these deformities could’ve been repaired with vacuum devices.”
Robert J. Obermeyer
The suction bell therapy is the first use by pectus excavatum specialists of a non-surgical device.
Dr. Obermeyer also said, "CHKD has always made attempts to decrease operating, and I believe this could wipe out the need for surgery in some pectus excavatum patients,"
In the video below, you can see Dr. Obermeyer appying the vacuum bell to a patient with a sunken chest, who doesn't want to undergo a surgery.
The VB device is used in Europe for several years, yielding incredible results. Investigation indicates that the chest improvement could be permanent.
Dr. Obermeyer went to see pectus experts in Switzerland who used the vacuum bell effectively. Ever since he has been active in bringing the vacuum bell technology to the United States.
However, it is strange how the vacuum bell therapy for pectus excavatum is still dismissed by conventional medicine as an "alternative method." It shows that many doctors are not seriously concerned with the non-surgical treatment of the deformity.
Every established surgeon prefers to operate. That’s what they studied and learned in medical school. I really can’t blame them at all. That is the way they earn their money.
Since the beginning of the health system, there was nothing but surgery in correcting pectus excavatum. Now there is an alternative, the vacuum bell method.
Plenty of scientific studies show satisfactory results when it comes to vacuum bell correction for pectus excavatum. Also, a lot of surgeons worldwide start to implement the VB therapy for their patients.
The placing of the suction cup in most cases is done favorably over the center of the hollowed chest.
As a guideline, try to apply the device with the hose nozzle over the upper area of the sternum.
To attach the device, it's sides should be spread and moderately pressed to the body. It should tighten up by itself when its inner sides come into contact with the skin.
When vacuum applied, the VB should attach to your body by itself.
The vacuum force is generated when you release the suction pump that was pressed previously. To increase the negative vacuum pressure, press the suction pump again when it regained its original form.
To take it off, the vacuum bell needs to re-exposure to air.
For this to be done, you need to do the following thing.
At the end of a therapy session, you should turn the air inlet valve of the suction pump.
That is done so air will come into the device slowly, to avoid sudden aeration.
As stated by Eckart Klobe, the pectus excavatum therapy with a suction bell has the following characteristics.
Notice how different these characteristics are in comparison to surgery. Also, with a Nuss procedure, you’ll have two titanium bars beneath your breastbone for three years.
The surgery is very painful and will limit you in physical activity for around 10 weeks. The suction bell can be removed at any time in the day, and you can continue to play your favorite sport with your buddies.
After that, you can put on the vacuum bell again.
That isn’t the case with the surgery. Removing the pectus bars will require additional surgery.
These are the most notable advantages of the vacuum bell therapy over an operation.
With the vacuum bell therapy, you are your own doctor. There is a lot of room for creativity. There is very little pain in comparison to surgery. If the pain gets intolerable, then you can take off the suction bell for a moment.
At the end of the VB treatment, there are no scars. You are uninhibited and can move freely.
However if pain and problems occur, you can’t turn to no one. You stand relatively alone.
The pain isn’t too bad for a painkiller. There is no need to go to the doctor if a blister on the skin occurs.
If you want lasting successes with the vacuum bell, it takes a lot of time and discipline. You need to consistently apply the device during the day.
With the vacuum bell therapy, you are your own doctor. There is a lot of room for creativity. There is very little pain in comparison to surgery. If the pain gets intolerable, then you can take off the suction bell for a moment.
As an adult or teenager, you must clench your jaw and go on. You must continue the treatment for at least three months.
Some patients think that there is no correction at all and become impatient. Usually, there are no doctors to motivate them to continue the therapy.
Lately, an Optical Scanning Device is used for impatient patients to notice the differences before and after the vacuum bell treatment. The goal of this method is to keep these patients motivated.
Use the comment section below to discuss your experience with the device.
If you have any questions and problems regarding the suction bell therapy, feel free to leave a comment below. I will gladly respond and help you with the situation you’re dealing with.
There are plenty of advantages of VB therapy over surgery. These advantages are enough for patients to choose this non-surgical treatment over minimally invasive procedures.
Purchasing Eckart Klobe’s vacuum bell is a complicated process. It can only be ordered from Germany.
The process of ordering is even harder for those that don’t speak German.
To order, you must send direct letters to the originator and producer of the vacuum bell, Mr. Eckart Klobe himself. You can find his contact information on his website.
Before ordering, a doctor must confirm your suitability for the vacuum bell on a form. If everything is right, you’ll get a "declaration of acquisition." Then, you send this form to Mr. Klobe.
If your doctor isn’t willing to do that at all, Mr. Klobe can find you doctors who are familiar with the vacuum bell therapy.
There is also another good company that builds great vacuum bells, similar to the Eckart Klobe's. The manufacturer is called PectusHealing.
You can order the device immediately, from their website. You can check my review on the PectusHealing vacuum bell below.
Ordering the Eckart Klobe's vacuum bell can be complicated if you can't speak German.
best deal for today
As of this writing, the vacuum bell cost starts from around $200 and above. There may be additional shipping and VAT costs, depending on your location.
As of October 2019, the vacuum bell is not categorized as a so-called "medical device." That is why health insurance companies can’t cover the costs. Consequently, the vacuum bell treatment isn’t accessible to all patients. That’s because of high-cost reasons.
With that being said, in most European countries, the vacuum bell needs to be purchased by patients or the patient's parents. It is not covered by health insurance.
The same goes for nearly all countries in the world.
In the United States, it is still considered an experimental treatment. Because of the small history of practice in the US, it is not covered by insurance.
Marshall Kapp, who is an FSU College of Medicine professor, said the vacuum bell device is currently in the gray area, also known as the “innovative phase.”
It’s evidently past the research stage since it’s been approved by the FDA. Nevertheless, it is not yet considered standard care to be covered entirely by insurance.
In some countries in South America, the accusation of the VB is covered by the distinct national health care system or the local insurance.
The Eckart Klobe's vacuum bell is priced 615.15 Euros, with a 2% discount for fast payment. You can buy vacuum bells from other brands for around 200 Euros.
In addition to the device’s cost, depending on where live, you must pay for the doctor’s appointment. That dramatically increases the cost of the Klobe’s vacuum bell, which at the end of 2018 was priced at 615.15 Euros, with a 2% discount for fast payment.
However, if you live in Germany, the health insurance pays for the doctor’s visit.
Honestly, I think this is the reason why the vacuum bell therapy in correcting pectus excavatum isn’t widespread among patients. Patients aren’t aware of the benefits of this therapy. Also, ordering the suction bell from Germany is discouraging.
If you live in the United States or Australia, the shipping costs will be too high. On top of that, the delivery time can be very long.
Luckily, there are other manufacturers of vacuum bells that are built upon Eckart Klobe’s principles.
If you’re suffering from pectus excavatum, there is no better financial investment in your’s future than a vacuum bell.
A lot of people think that vacuum bells are overpriced. Because of this, they don’t make a purchase.
This is true but to a certain extent.
Look at the shoes you got on. Look at the expensive car you’re driving, the clothes, shoes, jewelry, and makeup you’re wearing.
I guarantee that you won’t hesitate a bit to buy a new pair of shoes priced above $100, or the new iPhone that costs four times as much as a vacuum bell.
Surprisingly, the thought of investing in a device that will help you fix the unattractive dent in the center of your chest doesn’t even cross your mind.
If you didn’t know already, the pectus excavatum condition isn’t only cosmetic. Science has proved that it can harm your health. The dent may also get deeper if it is left untreated, making the deformity much more severe. The deformity can lower the life expectancy of a sufferer.
Scientists spent a lot of money and time developing a useful vacuum bell that will repair your pectus excavatum and change your life.
In my mind, investing $200 on this device will be the best decision you've ever done for your health.
Comparatively, the pectus excavatum surgery costs thousands of dollars. On top of that, you’ll live with two titanium bars below your sternum for three long years.
That is a painful procedure that requires a lot of pain medications. You’ll also need to avoid contact sports, because of a high chance of bar dislocation.
It isn’t surprising that the vacuum bell therapy for pectus excavatum is becoming more popular than a surgical procedure. The best part is that the effectiveness of this therapy is backed by science.
After repairing your funnel chest, you can always sell the vacuum bell. It is a durable product that can’t be damaged. The resell value will remain high.
This device is becoming more and more popular with time because of scientific evidence.
Investing in the vacuum bell is the best decision you can make if you suffer from pectus excavatum.
The vacuum bell treatment of pectus excavatum has a long history. The process of applying a vacuum to lift the sunken sternum was first used more than a century ago.
In Europe, the idea of a vacuum device to repair the concave chest deformity has been discussed for years. However, technology always trailed behind.
However, the first experiment wasn’t a success. The materials were insufficient, and adverse side effects occurred. The suction cups used in this time were made of glass.
On top of that, these suction cups were heavy, stiff, and unbearable to wear.
This stopped the use of this non-surgical method for fixing the concave chest.
Because of this, patients couldn’t wear them for long enough. They couldn’t see a satisfactory fixation of the raised sunken chest.
Ever since then, this method has improved considerably. Nowadays, it is an effective non-surgical method to fix the pectus excavatum deformity.
This method is also known as a cup-suction procedure, as defined in 2006.
Over the last few decades, the vacuum bell therapy development has stalled. The unsatisfying outcomes after pectus excavatum surgeries weren’t enough to motivate scientists to invest their time and energy in improving the vacuum therapy.
During the 1990s, materials for vacuum devices have greatly improved. This made these devices capably of applying powerful forces.
In 1992, the German chemical engineer Eckart Klobe created an exceptional device for conservative treatment of pectus excavatum. With this suction device, he managed to correct his own concave chest in the years 1992 to 1995.
For two and a half years, he managed to elevate his breastbone to the point that no sunken chest was visible anymore.
Scientific studies concluded that the Eckard Klobe’s vacuum method proved to be promising and effective in both surgical and non-surgical correction of pectoralis excavatum.
In 1997, he registered his patent for procedures and equipment for non-surgical repairing of the indented chest.
The effectiveness of this method became popular among inverted chest sufferers. He decided to create an “everyday” suction bell. It had very little to do with his original model from 1992. He created hundreds of samples before developing a device that worked unfailingly.
In 2002 he applied for a patent for his “everyday” vacuum bell.
In 2003, Eckart K. founded his own business solely for the progression, manufacturing, and promoting of his useful vacuum bells. In Germany, vacuum bell is also known as "Trichterbrust Saugglocke". By 2004, the company already made the 400th suction bell.
In 2013, Eckart Klobe received the Strategy Award for Best Innovation.
The vacuum bells by Eckard Klobe are CE certified and patent registered. Nowadays, it is appropriately registered as a medical device.
Dr. Robert J. Obermeyer, who is heading the non-surgical correction of PE project at CHKD, met with Eckart Klobe.
He visited the manufacturing facility where these devices are produced. He became aware of the effectiveness and safety of the VB. That helped accelerate its classification by the Food and Drug Administration as a class 1 medical device, which permits the sale and use in the United States.
In the USA, the device was officially agreed by the Food and Drug Administration (FDA) in May 2012.
The elastic body of most vacuum bells are made of orthopedic silicone. It is very flexible, pleasant to wear, and very compatible with the skin. At the same time, it is exceptionally durable and easy to clean.
Its chemical and mechanical attributes are also great. Don’t worry about it causing chemical reactions on your skin.
Every single vacuum bell on today’s market has a viewing window. It is made of polycarbonate.
Polycarbonates used in VB are very tough. They are optically transparent. Through the window, you can see how your hollow chest raises when you apply vacuum.
It is made of polyamide. The screw-coupling in the middle of the hose nozzle and the viewing glass has a reduced steadiness.
If you break the hose nozzle, you can ask the manufacturer of the device for a replacement. However, the chances of this to happen are very minimal.
They’re made of PVC (Polyvinyl chloride).
Due to security hazards, the power of the suction bulb is restricted. Because of this, you should only use the suction bulbs that come with the device.
Back in the days, Eckart Klobe’s vacuum bell concepts could generate a powerful vacuum that was harmful to the skin.
As of October 2019, there are three popular vacuum bell dimensions: 16 cm, 19cm, and 26cm in diameter.
The size of the vacuum bell should be selected based upon the shape of your sunken chest and how wide it is. The patient’s age, height, and deformity asymmetry can also play a role.
Patients with localized malformation and children should use the smallest model (16 cm). The center of the suction bell should be placed above the deepest point of the pectus excavatum.
The sufferers with an asymmetric pectus excavatum (Grand Canyon type) should apply the smallest (16 cm) device in different spots. In my experience, the silicone of the 16cm and the 19cm models is a little harder than the more significant 26cm device and provides more negative pressure.
The medium-sized model (19 cm) is offered in an additional type with a strengthened silicon wall. It is meant for patients with big chest muscles or sensitive chest nipples. It is called the “bodybuilder” for a reason.
It is also designed for adult pectus excavatum sufferers who have a tiny but deep hole. If your height is around 1.85m, then the 19 cm VB would be perfect for you.
Get the largest vacuum bell size (26 cm) if your entire anterior chest wall is hollowed extensively (there isn’t a deep narrow dent). The silicone of this bigger VB is softer than the smaller devices. It also doesn’t provide the same amount of negative pressure as the smaller ones.
Moreover, a unique model is designed that fits adolescence girls and women. The silicon body of this model doesn’t have the usual circular shape. It is intended to be easily applied on a woman chest (not hindered by the breasts).
Of course, it is tough to choose the appropriate VB size without at least seeing one photo of the available sizes.
It is also critically important that the circular silicone ring of the suction cup rests on your chest, outside the hollow.
If the edges of the cup rest in the sunken area, the suction cup cannot raise the indentation.
If you’re not sure about the sizing, I’d recommend you get the medium-sized (19 cm), model. It has the benefits of both the smallest and biggest models. If the size doesn’t suit you, you can return the item with your money back.
Before ordering, make sure you check out all available sizes. Choose the one that is designed for your type of deformity.
It is recommended to try the first use of the VB under medical supervision.
If you choose to ignore this and start the treatment in your home, I advise you to have a relative or a friend right next to you.
You start by lying down to set the suction cup on your chest. It should be placed tightly and comfortably.
Slowly pump and increase the vacuum pressure. There shouldn’t be any noteworthy pain. Feel how the inverted chest starts to lift to the transparent glass of the device.
At this point, it is entirely natural to have mixed feelings. You’ll feel hopeful, but at the same time, you’ll feel slight discomfort.
Pump and apply negative pressure to the point where you feel a minor ache.
Then, carefully try to stand up and walk around your room. Notice how the device stays on your chest without falling. That’s the power of the negative pressure and the vacuum bell.
You can wear it underneath your shirt. Nobody will notice it unless you wear an extremely tight shirt. You can wear the VB and do the therapy at school, at work, when going for a drink with your friends, etc.
According to Eckart Klobe, 15 minutes of wearing time is enough for the first time.
Your goal isn’t to correct the deformity after one single therapy. The purpose of the first session is to get familiar with the power of the vacuum bell.
To finish the first therapy, you should do a follow-up Medical check-up.
A lot of patients are starting VB therapy on their own. Eckart Klobe managed to correct his deformity on his own, using the suction bell.
The first time I did the VB therapy, I wasn’t under any medical supervision. I had my parents and my brother right next to me. We were aware that VB therapy isn’t unsafe and doesn’t have any dangerous side effects. A lot of studies confirmed this.
The patient at home does further therapy. Wear the VB when you have the time.
After applying the VB for several weeks, it may be essential to take a break for several days. That’s done to dismiss any chest and skin sensitivity to external pressure.
With time, your protruding rib cage familiarizes with being raised out of the dent.
Then, you need to make fewer and shorter breaks. Additionally, extend the VB application time to several hours in a day.
It is also advised to do Medical check-ups every month. A month after starting the vacuum bell therapy, I went to my doctor. He was astonished by the fruitful results. That encouraged me to continue with the treatment to the point of total repair.
For long-term correction of pectus excavatum, you should continue to apply the vacuum bell for around a year. The length of the therapy depends on the severity of your deformity.
Don't rush the first vacuum bell therapy. Please be cautious and follow the guidelines that I listed above. Your goal in the first month is to get familiar with the power of the vacuum bell. Make it a habit to wear it on daily basis.
The most common vacuum bell complication symptoms are bruises and discolorations of the skin (subcutaneous hematoma), small red circular non-raised patches (petechial bleeding), pain in the upper back (dorsalgia), tingling of the upper extremities (transient paresthesia), and sternal discomfort.
If your skin turns blue after applying the suction bell, this is a hematoma (Bruise).
A high percentage of vacuum bell patients have such hematomas. This is nothing to be afraid of.
These hematomas usually go away very quickly, and recover on their own. Your skin will get used to the suction bell therapy within a week.
These side effects are only temporary and usually disappear with suitable daily use adaptation.
Generally, the vacuum bell therapy for pectus excavatum is considered very safe. Over the years, just a few problems have been reported.
Multiple studies demonstrated considerable improvements in the malformation’s depth and Haller Index with vacuum bell use. Also, they confirmed that this alternate method of treatment is both safe and effective.
Comparatively, the extensive use of Nuss procedures for correcting sunken chest raised the frequency of surgical complications. Plenty of studies reported increasing rates of near-fatal complications. Generally, injuries were caused to the heart and mammary vessels.
Because of these pieces of evidence, the vacuum bell therapy for fixing pectus excavatum has made this alternative therapy a focus of interest of sufferers.
The vacuum bell therapy may cause some skin complications. However, they usually go away on their own in a few days.
Vacuum bell therapy can’t cause a collapsed lung (tension pneumothorax).
Some people believe in this because tracheal suctioning is directly related to pneumothorax.
However, tracheal suctioning can’t be done with a vacuum bell. It is done by a suction device (completely different than a vacuum bell) to aspirate secretions from the airways, during surgical procedures.
Scientific evidence shows that Rehbein's method causes a collapsed lung during operation. This method is one of the few surgical procedures to repair pediatric pectus excavatum.
Pectus excavatum patients need to be cautious of the possible occurrence of pneumothorax, especially during minimally invasive procedures.
This may surprise you, but a pectus excavatum sufferer decided to create his homemade vacuum bell. The unreasonable price of the Eckart Klobe vacuum bell motivated him to create his suction bell.
The patient preaches that his suction bell is working very nicely. He saw a noticeable improvement in his chest wall appearance.
This seemed very interesting to me and decided to see how it can be manufactured.
You can see how he created his own vacuum bell here.
Truth to be told, I was amazed to see how motivated this pectus excavatum patient was. He didn’t have any excuses. Correcting his deformity without surgery was his only purpose. Nothing could stop him.
We must learn to innovate our way out.
However, I don’t recommend you build your own vacuum bell. The process is complex, and you will most likely mess it up.
As he said, you must be very careful with the Vacu Vin Wine Saver. It can generate a mighty vacuum that can damage your skin.
Also, you will fail a couple of times before you make it work. From a financial aspect, there won’t be any noticeable difference between a homemade vacuum bell, and one built from established manufacturers.
Likewise, please don’t put your health at risk. Investing in a vacuum bell should be your priority. Don’t consider the money spent on it to be a waste.
To conclude, homemade vacuum bells might work. But then again, there is a high health risk associated with them that saving a couple of dollars isn’t worth it.
Building a homemade vacuum bell isn't really cost efficient as many think.
On top of that, there is a high chance that you may mess something while building it. That can be hazardous to your health.
Five different sizes of vacuum bells would fit any adult patient perfectly. The medium size “bodybuilder type” vacuum bell is built for adult patients.
It has a reinforced silicone wall , which has a higher capacity of applying negative pressure.
Correction of pectus excavatum for adult patients with vacuum bell therapy is possible. This is backed by science.
Doctors believe that adults have an advantage over teenagers, mostly because their ribcage is firmer and more stable. The adult sternum doesn’t fall back into a sunken position as fast.
For example, Dr. Eckart Klobe fixed his deformity in his adulthood for 2.5 years. He repaired to the point that no dent was noticeable any longer.
The daily application will differ from patient to patient. For example, grownups will have difficulty applying the vacuum bell at their workplace. Comparatively, kids have a lot of free time, which they can use for correction.
The anterior chest wall of adult sufferers isn’t as flexible as younger patients. This will increase the duration of treatment.
The fixing of adult pectus excavatum, with the vacuum bell therapy, is anticipated to last 24-36 months.
However, this time frame isn’t set in stone. Two patients at the same age may have a different chest wall stiffness. Because of this, if they apply the vacuum bell for the same time amount, one may see better results than the other.
For example, if the adult patient is more motivated and disciplined than the other, he will see faster and better results.
Therefore, I am a massive advocate of discipline. Make it a habit to apply the vacuum bell daily, even when you don’t feel like doing it.
Some motivated adults with inverted chest apply the vacuum bell during office hours, for 8 hours a day. They don’t care what their coworkers think about them. Their purpose of correcting their abnormal chest without surgery is higher than other people’s judgments.
Eckart Klobe corrected the dip in his chest with a vacuum bell in his adult years.
Adults have an advantage over younger patients when it comes to VB therapy, because their anterior chest wall is less flexible.
When you use the Vacuum Bell, your sunken sternum is pulled up, so it comes close to the viewing window of the device. Younger patients’ chests can almost touch the transparent glass within two weeks of therapy.
Comparatively, older patients or patients with severe pectus excavatum need more than four weeks to reach this point.
However, during the first weeks, it is essential not to accelerate this process. Stronger vacuum or prolonged therapy times aren’t required.
Lifting the hollow breastbone too fast is unnatural. It can lead to needless loss of the rib cage stability.
At the end of each treatment session, patients will experience the chest to remain in an elevated position for a few hours. After that, it slowly falls back to a concave position.
The chests of the adults will stay in the raised positions longer, in comparison to younger patients.
Your posture and overall body appearance will improve considerably. Your chest will remain flattered in between one treatment and the following one, usually the next day, in comparison to the beginning of the therapy.
In numerous instances, the improvement was stated to be about 0.4” (1 centimeter).
The effect of the suction bell is most evident during the first 12 weeks.
From the 4th month, the dent reduction is about 1 mm / month.
The patient will have much more physical endurance. Lung capacity and heart functioning will improve. You’ll experience a deeper breath, because of the chest expansion.
However, the effect of the suction bell is most evident in the first 18 months.
By this point, patients should have the habit of applying the Vacuum Bell therapy daily. It shouldn’t feel like a responsibility because your body and your mind will get used to it.
From the 18th week and on, the reported monthly dent reduction is about 0.04” (1 millimeter) per month.
At the beginning of the therapy, it is enough to apply the vacuum bell two times a day for about 30 minutes. The frequency and wearing time should be increased later in the course of the therapy.
Your body needs to get used to the vacuum bell during the first weeks of therapy. Learn to listen to your body. Don’t force yourself to wear the vacuum bell for about 8 hours in the first week.
If you do that, you’ll feel resentment with using the device. You can’t form a habit this way.
According to Mr. Klobe, it is always recommended to start slowly and increase the duration with time.
Start applying the vacuum bell for about 30 minutes a day when starting. Then, gradually increase the duration.
When you start the VB therapy, always pump until your inverted chest becomes flat. You can see this through the see-through window of the suction bell.
Consider this as a “warm-up” for your chest.
Wait 5 minutes until the chest relaxes and gets used to this new elevated position.
After the 5 minutes pass by, I squeeze the sucking ball together three times. Then repeat and pump every 5 minutes.
I always wait until the unpleasant sensation diminishes. After about 20 minutes, the hollow chest is almost touching the window of the suction cup.
At this point, pumping doesn’t do anything. I can’t elevate it further because that is as far as it could go.
When your chest reaches this positioning, I recommend you sit in this state for about 40 minutes. After 60 minutes, let air in and finish the successful 1-hour therapy.
Try to pump until the sunken chest is raised up to the transparent window. Listen to your body. If you feel sharp pain, stop immediately.
I’ve stumbled upon many patients that complain about a problem with the negative pressure maintenance. They had to pump to maintain the elevated breastbone to the window continually.
This is very irritating if you’re trying to do therapy while sleeping. During the day, you can pump to maintain the negative pressure. However, it is a whole different story at night.
I had this exact problem while sleeping.
As soon as I woke up, I noticed that the suction cup stayed loose on my chest. There was a very minimal vacuum whatsoever.
There are two things that you must adjust to. The first problem is caused because the pump ball and the valve are not tight.
After pumping and reaching the desired chest elevation, take the pump off. At the same time, squeeze the hose tightly so no air will come out.
The vacuum bell usually comes with a silicone plug designed for this purpose. If it doesn’t include one, any circular item made of metal, plastic, or silicone with a diameter of around 7mm will work. You can grind it out to become cone-shaped. Then, it would be much easier to insert it.
Stick the silicone plug (stopper) in the hose, and you’re good to go.
After doing that, the device should work correctly and stay tight without pumping!
See the following video.
The second problem is with the suction cup positioning on your chest.
If you try to sleep with the VB applied, you should put it a little lower on your chest.
Contrary, if you place it in a higher position on your chest, the air will slowly get drawn out of the device. You can hear the air getting out.
The vacuum bell has plenty of disadvantages that are worth mentioning.
The most significant disadvantage is that it is monotonous, annoying, sometimes uncomfortable. It’ll bring a substantial improvement to your chest deformity, but you’ll never be able to fix it completely.
With the vacuum bell, your funnel chest will never entirely disappear from your mind. You’ll be reminded that you have a chest abnormality daily.
For example, if you wear the device for an hour, you’ll be mentally busy on your indented chest for an hour. You’ll get impatient, and you’ll always look at yourself in the mirror. You’ll wonder how much the sternum raised, how deep it will fall back, etc.
To conclude, your pectus excavatum will become a more substantial part of your life than it already is. That will last at least a year, depending on how severe your deformity is and how long it’ll take to correct it.
The psychological strain was the exact reason why I decided to meditate. I felt a major mental and emotional release while I was meditating with the suction bell applied. The purpose of meditation is to have an absence of thoughts. Make it a goal to release the thoughts and feelings of pectus excavatum.
When you are at home, applying the vacuum bell isn’t tricky. However, you’ll unavoidably get in situations in which the suction bell is very irritating.
Usually, while at school, on vacation with friends, out of the country semester with a shared room, when you’re intimate with your girlfriend, etc.
However, these disadvantages aren’t bad enough to convince you to opt for the surgery instead.
With time, you’ll get used to wearing the vacuum bell. During the first weeks, you’ll feel annoyed. But, with time, these feelings subside.
The advantages are enormous in comparison to the disadvantages.
With that being said, please think for yourself and decide which type of treatment will work best for you.
The VB therapy can be boring, monotonous and requires a lot of discipline. Even though you will see amazing improvement, you still won't be able to completely raise the dent permanently.
The vacuum bell can be used even during sleep.
In my opinion, this is the best time to wear a suction cup.
However, many patients are uncomfortable falling asleep with their suction bell lifting their sunken sternum. If you’re a lucky one not to be bothered by the vacuum, feel free to use it during sleep.
That's about 5-6 hours of vacuum bell therapy a night. If you’re changing a lot of positions while sleeping, there is a high chance that you’ll dislocate the device.
I am such a sleeper, and I had to wake up 2-3 times to create new negative pressure.
If you had a busy day at school at work, there is no excuse not to use the vacuum bell. Nighttime suction treatment is excellent to make up for the lost time in the day.
That way, you can easily reach a minimum of 8 hours of vacuum bell therapy a day.
As a rule, the more you use the suction bell therapy in a day, the faster you’ll notice results.
In my opinion, using the vacuum bell while sleeping is the best time of the day for a therapy. However, not everyone can sleep with the device applied. It takes a few weeks to get used to the feeling.
At first, you’ll have an unpleasant feeling while trying to fall asleep with a vacuum bell on.
However, after a month, you’ll get used to it, and the strange feeling will disappear.
If you sleep lightly, there is a high chance that your chest will still stay vacuumed to the window of the VB, even after you wake up.
The suction bell wearing time is different from person to person. That strongly depends on how sensitive your skin is. The only way you can know whether your skin is sensitive or not is to try it!
However, skin irritation isn’t something important to worry about. You should pay more attention to the health dangers of the inverted chest. The skin renews very quickly, but the concave chest has the potential to harm your heart and lungs.
That’s why you need to apply the vacuum bell as often as possible, for faster and better results.
When I first started the therapy, I had skin problems while I was wearing it for more than 1-2 hours. At that time, I figured out that the problems were caused by skin dehydration.
I had horrible skin irritation for a long time. That prevented me from applying the vacuum bell therapy daily. Unless you interrupt the treatment for a few days until it heals, the redness will hardly getaway.
I started treating the skin after each session of wearing a suction cup, with moisturizing body milk, once a day. After doing that, I didn’t have any skin complications. I had days when I wore the suction bell up to 6 hours.
I have always used pure almond body oil that my mother bought for me. I highly recommend you the L'Occitane Almond Body Oil. It works perfectly.
That’s a great body oil to protect the skin from the harsh negative pressure.
Skin irritations are quite normal to occur. To minimize complications, it is best to use moisturizing body milk, baby powder and Fenistil gel.
This problem occurs when you vacuum too harshly, without a gradual progression. Remember to start lightly and increase the vacuum over time.
I experienced the blisters for three times during my therapy.
Usually, the blisters are filled with liquid. I always cut and drained them with a clean fingernail. Then I disinfected them with Ethanol. After that, I applied chamomile.
The alcohol works as a disinfectant, and the chamomile mixture is anti-inflammatory.
Apply Penaten Cream from Germany at night. It contains zinc-oxide that serves as a protective coating for mild skin irritations. It also promotes the healing of chapped skin and diaper rashes.
Just in case, you should continue the VB therapy only when the sores are healed.
If you continue to use the vacuum bell while the blisters are unhealed, then there is a high chance to put new secretions into the skin sore.
Don’t concern about the few days break. The hollow will stabilize again, and the chest elevation will then last longer.
Stop applying the vacuum bell if blisters occur. It will only make the blisters worse.
Itching during VB therapy is very unpleasant. It usually happened during the hot summer days while my body was sweating excessively.
I found a simple way to deal with this irritating itching.
Before applying the suction cup, massage your itching area with a towel, soaked in hot water. Then, use a dry cloth to absorb the water off your chest. After that, use a hair-blower to dry the area thoroughly.
Make sure that everything is dry before applying the VB.
The massage promotes blood flow to the nerve endings, which are responsible for the itching. This stops the skin irritation.
I learned this method from a fellow pectus excavatum sufferer, who was using the vacuum bell therapy for several months. At first, the vacuum caused him excessive redness, rough, scaly skin, and even blisters.
He was in pain. However, he managed to find a solution to this. He didn’t give up on the VB therapy and was be able to correct his 4 cm deep inverted chest.
After doing the hairdryer trick, he managed to wear the VB for 5 hours on average.
So, here’s the trick.
Before putting the vacuum bell on, make sure it is completely dry. Also, make sure your chest skin is dry too.
It is best to use a hair blow-dryer to dry the area quickly.
After doing this, expect the redness and other skin problems to disappear in a few days.
Dry the suction cup and your chest with a hair blow-dryer to minimize redness.
The first impression of the vacuum bell was a bit surprising. I didn’t expect it’d be that big. I always imagined it being smaller. It is so big that it covers the entire thorax.
The device is shaped something like a giant, silicone doughnut.
I was thrilled and delighted. After I used it the first time for around 20 minutes, I instantly noticed that the lungs have much more space. It expands your entire chest.
After using the VB for about one and a half weeks, I managed to pump up the dent up to the glass. The morning after doing this, the indentation of the pectus excavatum (was 2.5 cm deep before starting the treatment) came to 1cm!
I was delighted with it.
I was a bit hardcore with the VB because I pumped until real chest pain occurred. The motivation to fix my pectus excavatum deformity was too high at the time. Tolerating pain was a piece of cake for me.
I had no problems whatsoever. My chest skin was wonderful. The VB caused it to be reddish because of the sharp curves of the suction cup. Ten minutes after taking off the device, everything was normal again.
At the time, I was 18 years old. I must give a lot of credit for my success to my doctor. He was extremely positive and motivated me on every appointment.
The feeling of suction is extreme. When I tried to speak, I noticed an energetic vibration in the chest.
Generally, it is a gratifying sensation of pain that lessens after a few minutes.
At the start, I could only use the device for a few minutes. The pain was tolerable. However, chest circulation sometimes goes crazy. During the first few days of therapy, I felt the need to lie down.
After three days of therapy, I saw that my funnel was gone entirely through the transparent viewing window.
After taking off the device, the sternum stayed in an elevated position for around 2 hours before it fell back. However, it doesn’t fall back to the old depth. It stayed elevated for a couple of millimeters.
That was proof that the vacuum bell therapy could correct pectus excavatum. I was so motivated that I continued to use the device without taking a day off.
It works just like a dental brace. If you do not wear them daily, the teeth will return to their original state. For best results, most patients wear braces from one, up to three years.
The beginning phase is always the hardest. After a couple of days, you’ll get used to it.
After five weeks, I could apply the VB without any problems for up to 2 hours and even more.
Since I’ve been wearing the VB daily, I decided to take a six-week pause. I wanted to give my skin and bones some rest.
During the break, the dent fell back by only 0.2 cm, while it was raised by 1.5 cm. The red circle and the darker discoloration in the center of the hollow were gone during the break. I didn’t have any problems with the blisters. I wrote about the way I deal with them in the text above.
My orthopedist advised me to wear the vacuum bell as long as possible. He told me that the sternum would get back to the sunken position if I only wore it for an hour a day.
At that time, I was still a high-school student. I was in my senior year.
He counseled me to wear the vacuum bell during the whole night, while I was sleeping.
I removed the device while I was preparing for school in the morning. I made a habit of putting on the vacuum bell as soon as I came back home from school. Usually, I wore the device for 2-3 hours.
If you do the math, that is an 8-10-hour vacuum bell pectus excavatum therapy a day.
With this simple tip that I received from my orthopedist, I managed to lift my sunken sternum in normal positioning, in about two months of therapy.
I was highly motivated to correct my pectus excavatum deformity. It was ruining my life on a psychological level. I ignored the red skin rashes that formed around my chest. All I focused on was fixing my inverted chest without surgery.
Generally, the younger you are, the faster you want to get rid of pectus excavatum. The older you get, the more cautious you turn out to be.
The suction bell didn’t impact my training negatively. Surprisingly, it was an extremely positive experience!
I focused mainly on my chest, core, and my back. Back training should never be neglected. Those muscles are responsible for keeping your posture upright and sturdy.
The combination of physical therapy and suction bell treatment made the dent in my chest unnoticeable.
Performing bench press, dips, chest flys, dumbbell pullovers, pull-ups, and rows will have a tremendous positive impact on your deformity. Weightlifting will strengthen you both mentally, physically, and will help you build discipline. This will help you in the vacuum bell applying consistency.
These exercises are a great way to improve your posture and strengthen your upper body muscles, especially the pectorals. They will improve your muscle tone, making you more attractive to the opposite sex.
I didn’t have any struggle with the discipline of applying the VB daily. I genuinely believe that weightlifting was a direct factor for this. I always thought that performing these heavy exercises was ten times harder than having the discipline to put on the suction cup for a few hours in a day.
If you have the habit of going to the gym for a few days in a week, then applying the vacuum device will be a breeze.
Additionally, I highly recommend you do yoga, Pilates, or other posture improving exercises before starting the VB treatment.
That will stretch your anterior chest wall.
Placing the suction cup directly over the dent will be much easier. Also, the chance for the vacuum bell to fall off your chest will be significantly minimized. Walking upright with a stable posture will ensure that the suction cups stay on your body tightly.
Combining weightlifting and vacuum bell therapy will make the dip in your chest much less noticeable. Your chest muscles will be toned and muscular, which can also increase your confidence to show your abnormal chest in front of others.
Of course not.
The solid bone structure isn’t reshaped with the Eckart Klobe suction bell.
However, the internal joints around the sternum are moved, the rib cartilage is bent, and the connective tissue fibers and ligaments are stretched.
Yes, but only while you have the vacuum bell on.
A lot of patients that have a compressed heart and lungs feel a noteworthy relief while applying the vacuum bell.
The device decompresses their chest. The patients instantly feel their lungs expanding to a point they never felt before.
However, this type of correction is only a mobilization of the chest.
After you take off the vacuum bell, the dent in the chest will fall back again.
It takes plenty of weeks of consistent VB application before the funnel remains stable without a suction cup.
That is possible.
In most cases, the caved-in chest is closely associated with postural flaws such as scoliosis, round back, forward head posture, and rounded shoulders.
According to Dr. Eckart Klobe, correcting the posture problems with stretches and physiotherapy exercises will aid in faster repairing.
During the first months, you should finish the most straightforward steps. Those are chest mobilization, improving posture, and upper body muscle strengthening.
The most tedious and challenging task during the vacuum bell therapy is stabilizing the sternum in a raised position.
The mobilization phase during the first three months stretches the fibers, ligaments, and joints in the anterior chest wall.
Mobilization is done by applying the vacuum bell on the inverted chest for at least an hour a day.
For them to stabilize in an elevated position permanently, the sternum should be kept in a raised position as often and as long as possible.
To simplify, try to increase the duration of the VB application gradually. Try to use the device while you sleep. Aim to wear the VB for at least 4 hours a day in the second phase (month 3-6).
Essentially, as much and as long as possible. That’s how you correct the pectus excavatum deformity in the shortest time frame.
However, individually, there are lots of significant differences.
Some patients can tolerate only a half an hour of VB application. Truth to be told, that isn’t enough to correct the funnel chest without surgery.
Usually, sensitive skin is the biggest reason why patients can’t endure a half-hour VB therapy session.
You must learn to listen to your body. If you’re feeling severe aches, please contact a specialist and stop the therapy.
If everything goes smoothly, in the first weeks, you will be able to tolerate shorter therapy sessions. With time, you should increase the wear time gradually.
To clean the suction cup, you need a soft cloth. You can moisten it with either pure water, soapy water, or alcohol.
Never use propanol or isopropanol. Propanol makes the vacuum cup cloudy.
Always be careful with ordinary disinfectants. Most of the time, they usually contain propanol. Therefore, they’re unsuitable.
Often, a lightly moistened cloth with clean dishwashing soap is more than enough.
While cleaning, please don’t soak the cloth into liquids. Make sure the rug is only slightly damp. That’s because the valves of the suction bell don’t tolerate water and will leak.
Just like I previously mentioned, the ideal age for vacuum bell therapy still needs to be specified.
Doctors believe that both children and adults have some advantages and disadvantages of VB therapy.
For example, physicians believe children with congenital PE have an overall advantage over adults in chances of successful correction with the VB. Their bodies are still growing, and their anterior chest wall is more flexible. Also, they will be more motivated to fix their deformities than adults.
Alternatively, adult patients can benefit from an entirely different advantage. Unlike most children, most grownups have the breastbone raised after wearing the VB.
After a couple of hours, their sternum slowly sinks back.
This is perfect if you want a carefree swimming pool experience. Also, you can do this before going to the nightclubs or bars. Members of the opposite sex won’t notice that your chest is malformed.
It also allows for adults to distribute the VB application throughout the day. That way, the dent can barely sink back in between.
For example, apply the VB for one hour in the morning, one hour in the afternoon, and one hour in the evening. That way, the chest will stay in a normal position throughout the entire day.
Younger patients are usually more motivated to fix the dent in their chests than adults. Their chest wall is more flexible, which makes it easier for the vacuum bell to pull the dent up to the viewing window of the device.
The power of a regular vacuum bell is enough to lift a maximum of 1 kg per square centimeter.
Truth to be told, this isn’t enough to lift a sunken sternum.
However, the suction cups that are designed to fix pectus excavatum can generate mind-blowing force.
Let’s take Eckart Klobe’s vacuum bell, for example.
The surface of his circular VB is 20 cm in diameter. That’s roughly 315 square centimeters.
This device can lift a total of 314 kg with full vacuuming.
With partial vacuuming, the suction forces are congruently lower. For example, if you use 15% of the vacuuming power of the device, it is enough to pull around 47 kg.
That’s why modern vacuum bells can pull out the indented chest to the transparent window of the device. Some patients use the maximal capacity of the VB, so their inverted chest goes into a pectus carinatum shape.
Of course, the breast becomes hollow again, but it doesn’t fall back to the original position.
The vacuum bells are extremely powerful. They can pull up to 314 kg with full pressure applied.
Eckart Klobe clearly stated a few circumstances in which the Vacuum Bell should not be used.
Don’t use the VB therapy if you suffer from diseases that alter the strength of the bones.
Such diseases are:
In the case of Angiopathy. That is a standard term for an illness of the blood vessels (veins, arteries, and capillaries).
These can result from:
If you suffer from Coagulation Dysfunctions. These are disturbances in the body's capability to regulate blood coagulation, involving:
There is a discussion between patients and physicians, whether using VB therapy before an operation is helpful.
However, the vacuum bell cost in the United States needs to be covered by the patients. Because of this, most patients aren’t interested in this “pre-therapy.”
Recent studies showed no remarkable difference between patients that did the VB therapy before surgery and those who opted directly to primary surgery.
In my opinion, there is no reason to purchase the vacuum bell device if your end plan is to opt for a Minimally Invasive Nuss procedure. It’ll only add up to the costs.
The vacuum bell is powerful enough to fix the pectus excavatum deformity on its own.
Don't purchase a vacuum bell if you plan to undergo a surgery to fix your chest.
The best possible age for vacuum bell treatment is yet to be identified.
Studies are continually examining variations of success dependent on age. After making a growth spurt in puberty, the pectus excavatum severity will be at its peak.
Additional studies need to determine if starting the VB therapy before, is better than starting it during or after puberty.
If you want to see progress and success, you must measure it!
I used to measure my chest with a ruler weekly and note the result on paper.
The vacuum bell therapy requires a lot of patience. It is hard to notice the results just by looking at yourself in the mirror.
At one phase, I forgot to measure the depth of the funnel chest. I had two listless phases behind me. I thought that progress has stalled and lost some motivation.
However, I did another measurement after these two months and was stunned by the results. I looked at my table and saw that great improvement was made since April.
I regained the motivation simply because progress was evident on paper.
It’s hard to notice any improvement in the caved in chest, especially if you look at your body every day.
The vacuum bell therapy won’t be effective for the impatient! Always remember, the funnel chest correction can take up to 2 years!
Another useful measurement tip is to take photos (front view and two sideways views at 45° and 90°).
First, take photos before starting VB therapy. After that, take pictures of your chest every two weeks. Import these photos to your computer. Make sure you save them to a Cloud Storage service because a single computer crash can be fatal to your photos.
Remember to measure your chest after taking off the device for 14 hours. As you already know, the chest will be raised to a normal position after each session of VB therapy. It will gradually fall back to a hollow position, but not as deep as before.
That’s why 14 hours of wait is required to have the same foundation.
After measurements and taking photos every week, I can proudly say that I raised the dent by 2 mm every month. If you do the math, that is 2.4 cm in a year! That is more than enough to correct the deformity and make the sunken chest less visible.
If you have a more severe case of pectus excavatum, you must continue with the treatment even after a year. Be patient, take measurements, and trust the process.
I wish you continuous achievements and persistence!