Pectus excavatum is a congenital anomaly of the anterior chest wall with a sharp concave curvature of the body of the sternum, from above downward and from side to side, especially just before the junction of the glandioloxiphoid. There are two major operative procedures -"Ravitch" or "Wada" operation- for the correction of pectus excavatum. We used the modified Ravitch operation which consists of mobilization of the sternum, transverse osteotomy, and parasternal resection of the costal cartilages followed by placement of Marlex mesh using methyl methacrylate behind the sternum and suturing the edge of the Marlex mesh to the peripheral stump of the resected ribs. This was performed in a patient with severe pectus excavatum with good results at the Department of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine in Seoul, Korea on January 12, 1989.anuary 12, 1989.