Many of us can remember having one physical trait—knobby knees, kinky hair, maybe a broad forehead—that made our childhood a living hell. We often have a moment we can recall feeling ostracized as the kids in the school yard circled around to ogle, point, or even laugh. That single moment tends to define our self-perception and the parts about ourselves we nitpick and fixate on. 25-year-old Flavia Mucciolo, an Oviedo, Florida native with pectus excavatum (or sunken chest), can't really pin-point that single moment. While, like so many of us, puberty served as a turning point in her self-perception, Flavia’s "culmination of little events” rewrites the simplicity of that “single-moment” narrative.
Growing Up with Sunken Chest
“Kids are the best because they don’t really notice differences in each other, and if they do register differences, they don’t care,” Flavia said with a laugh during our candid conversation on Zoom. “So, I think growing up as a kid, it was never something that I thought about too much.” Even through our computer screens, Flavia’s positivity and ease radiated. While she often referred to her own lack of self-confidence, the ease she carried was enough to soothe anyone in the room. She went on to explain that sunken chest doesn’t fully develop until adolescence, which also made it easier to bypass as a child.
Pectus excavatum, a birth defect in which a person's breastbone is sunken into their chest, ranges in severity. In Flavia’s case, the only true impact was aesthetic. Her sunken chest (coupled with a protruding sternum, known as pectus carinatum or Pidgeon chest) leaves a deep dent in the center of her chest. However, more acute cases of pectus excavatum can prohibit proper breathing, decrease exercise tolerance, and produce heart palpitations or respiratory infections. Despite the potential seriousness of pectus excavatum, Flavia and her family took her condition in stride.
When Flavia was 13 years old and her body began to develop, the increasing visibility of her sunken chest resulted in more concerns both externally and internally. She and her family went to a doctor to see if it was impacting her breathing and if treatment was necessary. Ultimately, she decided that surgery wasn’t the best option for her, and from then on didn’t look much into pectus excavatum beyond her own lived experience.
“I think the whole part of the really long recovery deterred me from even wanting to know more,” Flavia said. She was referring to the recovery process following an operation in which the breastbone is broken in order for it to re-heal in the proper placement, thereby reducing the chest’s concavity. The operation entails a five to six-month period with a metal bar in place to realign the breast bone, followed by a three to five-month healing process once the bar is removed. “Just thinking about what my life would be like...especially at the time because volleyball was my life, I loved volleyball. And so, I was like, ‘What the heck?! I don’t want to go a whole year without playing, this is a huge part of me.’” Since then, the only time Flavia’s looked up her condition was in preparation for this interview. It took 12 years for Flavia to search for pictures and do extensive research on pectus excavatum, mostly because after 12 years of not seeing sunken chest anywhere else in her life, she was thoroughly convinced she must’ve been the only one.
Representation (Or an Utter Lack Thereof)
“I think that’s where my mind went [because] I haven't seen anyone in person or on the internet with it,” Flavia said, "so I just dismissed it in that way.” That being said, Flavia’s own father had a very minor sunken chest. However, for every one girl with sunken chest, four boys have it as well (a fact both Flavia and I learned when preparing for our conversation). Not to mention that “the experience of a guy and a girl having this is very different” according to Flavia. Which makes sense; the beauty standards men face are not nearly as stringent as those of women. Considering the value placed on a woman’s delicate decolletage, finding female representation of sunken chest would’ve been particularly significant for Flavia.
“I don’t think there’s any representation at all in the media of [sunken chest]. It would’ve been so awesome to see an actress, a model...anyone, even like a friend or anybody who has this. I think seeing it in person or in a picture and having some kind of connection to it would've made such a difference,” Flavia said, wistfully. “And I would be curious to talk to somebody that has the same condition as me and say 'Did it bother you as much as it bothered me growing up? Do you wear V-necks? And why do you or do you not?’...But like I said, I’ve never met someone or seen anybody that looks like I do. So, yea, it would make a really big difference.”
Despite the lack of sunken chest representation in both the digital and real life, Flavia experienced no shortage of positive reinforcement from her family and friends. While some beauty standards exist to outwardly reject those who don’t mold to it, sunken chest didn’t present itself as something that isolated Flavia from the world. In fact, overtime she learned that in many cases, the only person who cared about her chest was her.
“If I’m hanging out with someone and the situation comes where I’m taking my shirt off because I’m going in the pool, or we’re meeting up at the beach and everyone’s undressing to go in the ocean, I used to feel like I’d have to give a pre-explanation. And I’d do it in a joking way; ‘I have this weird thing, this bone here [Flavia gestures to her breastbone]. So, just to let you know if you see it, that’s what it is. I was born with it. That’s all.’ Good explanation, right?" Flavia asked me, with a laugh. “I started to assess people’s reactions when I told them that, and when their reactions were ‘...Ok’ or 'I didn’t even notice’, I was like ‘Then why am I explaining?” Flavia laughed again; her good spirits infectious. "It clicked in my mind that if they are not losing sleep over this, then why should I? [But] If people ask, I’m so happy to explain.... I just kind of made that switch.”
While sunken chest was never a huge impediment on Flavia’s life and relationships, it did define her journey with self-confidence and self-perception.
“I remember going bathing suit shopping with my mom, which is always so stressful because we would go to 5 million places because I was trying to find a bathing suit that was cute but that covered my bone, too,” Flavia said with a hint of humored nostalgia. “I remember... the happiness that I had when I found one that was this really beautiful green and blue tie-dye bathing suit that didn’t look sporty, but it was cute, and it covered my bone. I remember that bathing suit, I don’t know why. I think it was one of the first ones where I was like, ‘It does it all!! It checks all the boxes!’” Flavia laughed. “Just for many years, it was hide-it-don’t-show it, because I was self-conscious about being different.”
However, between the friends, family, and even romantic partners along the way that always reassured Flavia that her sunken chest was “no big deal”, Flavia soon worked past her self-consciousness. Having grown up in Brazil, her culture’s propensity for body positivity also helped lessen insecurities.
“In Brazil...women show off their bodies a lot. So, if you go to the beach in Rio, which is where we lived, you’ll see a lot of very, very tiny bathing suits, for men and women. And that’s just the norm! So, it kind of also helps to be in that environment because you see people of literally every single body type still sporting the same tiny bathing suits," Flavia said. She explains that despite the slightly “more judgmental” beauty standards she perceives here in the U.S., the wholly accepting atmosphere she experienced in Brazil pushed her to accept herself. "My family in Brazil has also always been like, ‘Who cares! That bathing suit is so cute you need to wear it, it still looks good regardless of anything on your body,’ So that helps.”
Whether in her hometown of Oviedo or on the beaches of Rio, the journey of self-love is on-going, according to Flavia. Small victories along the way like daring to wear a triangle bikini or no longer giving the “pre-explanation" of pectus excavatum epitomize her growth.
It’s Not So Simple
Flavia’s humility and easiness when reflecting on her journey with sunken chest can be a reflection for all of us. Her friends’ support and her family’s acceptance only partially explain her positivity. The way she's carried herself throughout her life, let alone in our conversation, speaks volumes of her ability to see past the exterior. No amount of nitpicking or fixation—no matter how noticeable the defect or how troubling the childhood memory—will change who you are. And when you put it in perspective, that’s more than ok.
When I asked Flavia what she would want to tell the world about pectus excavatum, she quickly responded that she wouldn’t want to “make a huge deal about it”.
"There’s people in the world who have such bigger problems and bigger issues...I would just want them to know that it’s beautiful still. As long as it’s something that doesn’t harm you then don’t worry about it. It’s just one little portion of you, you have so much more to your body.”
And much like Flavia, so much more to offer the world.