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While the child is deep asleep and pain-free (using general anesthesia), an incision is made over the breastbone (sternum). The deformed cartilage are removed and the rib lining is left in place to allow re-growth of the cartilage. An incision is made in the sternum and it is repositioned. A rib or metal strut may be used to stabilize the sternum in normal position until healing occurs in 3 to 6 months. A chest tube may be placed to re-expand the lung if the lining of the lung is entered.
Metal struts are removed 6 months later through a small skin incision under the arm. This procedure is usually done as an outpatient.

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