Letter to Editor in response to:  The hidden (and fatty) side of vacuum bell by Tedde M

I would like to respond to Dr. Tedde's comments about the recently published study by Toselli et al. [1] and his concerns about the conservative treatment of pectus excavatum (PE) using the vacuum bell (VB). Dr. Tedde points out that, in his opinion, the effect of VB therapy is predominantly due to thickening of the chest wall by increasing pre-sternal adipose tissue in front of the sternum instead of remodeling the cartilage and bone of the sternum. Furthermore, he emphasizes this information is not mentioned in scientific reports nor on specific websites provided by health care providers and/or manufacturers.