Contents · 8 sections
You’re about to order a vacuum bell, and only two of the seven makers in this guide say they’ll refund one you’ve already worn. So the size has to be right before you pay, and there’s no single chart to read it from. Each maker sells its own sizes and asks for different measurements, and they don’t even measure the distance between your nipples the same way.
The way through is short: pick your maker first, measure the way that maker asks, test the outline with a paper template, get the size confirmed in writing, then check the fit at your first session. The table, checked on 20 October 2026, is right below.
I had pectus excavatum, diagnosed at 15, and corrected it without surgery over about three years. The change was visible and measurable, but not complete. I’m not a doctor. I also sell my own custom vacuum bell. It’s first in the table, on the same columns as everyone else, and no link on this page pays me a commission.
Vacuum bell sizes by maker (checked 20 October 2026)
Each row comes from the maker’s own pages or documents, and the order isn’t a ranking. “I couldn’t find it” means exactly that, so ask.
| Maker | Sizes (as the maker states them) | What you measure or send | Nipple distance | Who picks the size | If the size is wrong |
|---|---|---|---|---|---|
| mrpectus (mine) | Custom, 3D-printed; no size list | One measurement: nipple to nipple | Inner edge to inner edge | Built from your measurement; I check it before printing | 30-day refund, used OK, you pay return postage |
| Eckart Klobe (original) | Large 26 cm, Small 19 cm, Bodybuilder 19 cm, Women’s 19 cm, Mini 16 cm | Year of birth, height, weight, approximate depth, nipple distance, photos neck to waist, front and two 45° angles | Centre to centre | Klobe, from your details; Ventura, his Spanish distributor, requires a prescription | I couldn’t find it |
| FormaChest | Men’s XXS (approx. ages 4 to 7) to XL; Female S to L; letters, not centimetres, on the product page | Ruler measurements in a free online fit assessment, no photos (their description) | Not stated | They recommend a size from the assessment or a sizing consultation | 90-day refund, used OK, you pay return postage |
| Pectus Healing | 11, 12.5 (unavailable), 14, 16, 19 × 18, 22 × 21, 25 (MAX version unavailable), 26 × 21 cm; women’s 16 × 21 cm | Birthdate, height, weight, nipple distance, chest photos with a ruler, no face (email consultation) | Centre to centre | You, or their team by email | Used bells not returnable; one exchange within 14 days, only if their consultation chose the size |
| Pectus Solutions | One listed size, 19 × 19 cm, for ages 15 and up; their orthotist recommends 16 to 23 cm | Age, height, nipple distance, whether you have a doctor’s referral (free online form) | Not stated | Their orthotist | Free size exchange within 30 days; you pay to send the first bell back |
| Pectus International | One size, 19 × 16.7 cm; out of stock on 20 October | Nothing: there’s one size | Not needed | No choice to make | 30 days, unused only; restocking fee possible |
| Pectus Lab | Gvacuum, lengths from 80 to 190 mm; seven sizes, per its July 2026 post | I couldn’t find it | I couldn’t find it | A physician, per the same post | I couldn’t find it |
Prices, shipping and the full terms for each seller are in my comparison of where to buy a vacuum bell.
Klobe gives height guidance in his own 2019 article. These are approximate lower limits, not ranges, and Ventura says a medical specialist makes the final choice:
- Large, 26 cm: male patients taller than about 1.70 m.
- Small, 19 cm: taller than about 1.40 m. The bodybuilder and women’s types are also 19 cm.
- Mini, 16 cm: children taller than about 1.05 m.
The numbers don’t travel between brands. One maker’s “19 cm” isn’t another maker’s “19 cm”. Of the makers here, only Pectus Healing says what its number measures: the outer diameter. It adds that the area that pulls is smaller, because the soft rim is there to seal.
What about 22 cm? A 2021 review lists 16, 19 and 22 cm, but Klobe’s own documents and Haecker’s 2016 review give 26 cm as the large size. Pectus Healing’s 22 × 21 cm bell is its own model.
What the right size has to do
The dip is the sunken part of your chest. Ventura puts the fit rule well in its vacuum bell size guide: the bell is “a bridge, not a plug”. The silicone rim rests on the firm ribs around the dip, not in it. A bell that’s too small sits in the hollow and mostly pulls on skin and soft tissue.
Klobe sets the limit in both directions in his 2010 instructions for his own bell: large enough to rest on the area outside the dip, small enough not to press painfully on the throat, belly or, in women, the breasts, or to lose vacuum at its sides.
So a height chart alone can’t size you. Klobe weighs sex, age, height, weight, posture, the shape and depth of the dip and nipple sensitivity, plus the breasts in women, and writes that choosing takes experience.
Nor is there a tested rule to fall back on. In a 2024 paper, Haecker wrote that there are still no standardized protocols for patient selection criteria, the treatment schedule or follow-up, and I found no study that compares bell sizes or tests any maker’s sizing method.
Before you measure
See a doctor first. Klobe’s instructions say his bell is to be applied only after a medical examination. If you have a bleeding disorder, a heart or blood vessel condition, Marfan syndrome or fragile bones, get checked before you choose any bell. The full list is in my guide to vacuum bell therapy.
Pick or shortlist your maker. The measurements depend on it.
Gather the tools: two rulers (one rigid) or a ruler and tape measure, a printer, scissors, tape, your phone camera, and a helper, because most of this is hard to do on your own chest.
How to measure for a vacuum bell
1. Measure the depth of the dip
Lie flat, rest a rigid ruler across the dip without pressing, and measure straight down to the deepest point in millimetres. Repeat until two readings match. My guide to measuring pectus excavatum at home has the full method. That number is a tracking number, not a Haller index, and Klobe only asks for an approximate depth.
Done when: you have the same number in millimetres twice.
2. Measure nipple distance your maker’s way
This is the step most likely to go wrong, because the makers disagree. Klobe and Pectus Healing ask for the distance between the centres of the nipples. I ask for the distance from the inner edge of one nipple to the inner edge of the other. Pectus Solutions’ form doesn’t say, so ask them. On the same chest, the inner-edge number is shorter than the centre-to-centre number, so a figure measured the wrong way can point to the wrong size.
Done when: you have the number in centimetres with “centre” or “inner edge” written next to it.
3. Note your height, weight and age
Klobe and Pectus Healing ask for your birth year or date, height and weight. Pectus Solutions asks for age and height.
Done when: they’re written down with your other numbers.
4. Take the photos, without your face
Klobe asks for photos from at least the neck to the waistline: front, plus each side at a 45° angle. Pectus Healing adds front shots with a ruler across the nipples and down the middle, plus views from above and below. Neither asks for your face.
Done when: you have each view your maker asks for, in good light, with the ruler readable.
5. Test the outline with a paper template
Pectus Healing has free printable vacuum bell perimeters. Print at 100% with “fit to page” off, check the size with a ruler, cut it out, tape it centred on the dip and photograph it from several angles. Ventura’s check for the Klobe bell is a 19 cm paper circle held on your chest at a mirror, after first lying on your back to see the chest’s true shape.
The outline should cover the whole dip with its edge on firm rib, and stay clear of your throat, belly and breasts. Because the paper shows the outer size, Pectus Healing says to choose one of its models slightly larger than your sunken area. Ventura says the bell should ideally fit between the nipples. Slight edge contact may be unavoidable in some adults, but a nipple should never be the centre of pressure.
Done when: you have photos of the outline on your chest, covering the dip, with the edge on rib all the way round.
6. Send it, and get the answer in writing
Before you pay: Pectus Healing’s one exchange only applies if their consultation chose the size, and Pectus International takes back unused bells only. Read your maker’s wrong-size rule now, not after the bell arrives.
Send your numbers, photos and template shots to the maker or your clinic, and ask them to name the size in writing.
Done when: you have an email that names your size and the maker’s wrong-size policy.
If your chest doesn’t fit the usual pattern
Between two sizes
No study says which way to go. Pectus Healing leans to slightly larger than the sunken area for its bells, and Klobe’s rule caps the size at your throat, belly, breasts and sides. Send the maker template photos for both sizes and let them decide.
Uneven dip
Klobe centres the bell over the middle of the dip, even when it’s asymmetric. Haecker and Sesia’s 2016 review adds that applying it in different positions could be useful, and Pectus Healing’s consultation weighs asymmetry. Make sure your 45° photos show the deeper side, and ask where the bell should sit.
Narrow and deep, or wide and shallow
The same 2016 review says a small bell could help when the dip is localized. At the other end, Pectus Healing points wide dips to its largest models and sells the 26 × 21 cm only after sizing confirmation. Its consultation also weighs flared ribs, lower ribs that stick out.
Women
Klobe’s women’s type is 19 cm and curved in at the sides to take pressure off the breasts, usually enough up to bra size A and B, sometimes C (German sizing). Ventura lists cups A to C (EU). Pectus Healing sells a women’s 16 × 21 cm for narrow dips, and FormaChest a Female S to L. Pectus Solutions says it doesn’t offer its bell to women.
Children and teens still growing
Klobe’s Mini (16 cm) starts at about 1.05 m. Pectus Healing makes 11 to 14 cm bells for children, and FormaChest an XXS (approx. ages 4 to 7) and XS (8 to 13). Buying bigger to grow into works against Klobe’s small-enough rule, and a child may need a new size as they grow. Cincinnati Children’s fits a specific size in clinic and sees the child every three months, and Haecker advises parents to supervise children under 10. More in vacuum bell therapy for kids.
Big chest muscles or sensitive nipples
Klobe’s bodybuilder type is 19 cm with thinner, softer side flanks, so it can sit more comfortably over big chest muscles or sensitive nipples, or along a horizontal dent at the line of the diaphragm. His instructions warn that big chest muscles can be drawn into the bell and reduce its effect. Pectus Healing says its 25 cm MAX suits bodybuilders, but it was unavailable on 20 October. Confirm the model with the maker or your clinician.
How sizing works for my bell
This is my bell, so weigh this section knowing that.
Every bell is built to your chest from one measurement: the distance from nipple to nipple, inner edge to inner edge. I check the measurement before I print, and if something looks off, I contact you before anything is built. The details and terms are on my vacuum bell page.
What I can’t tell you is that custom is better. I know of no evidence either way that a custom bell fits, seals or works better than a fixed size, and no published study has used my bell.
Check the fit at your first session
Klobe’s instructions say the first application should happen with medical guidance. At that session, check:
- the bell sits over the middle of the dip, with the hose nozzle usually over the upper breastbone
- the rim rests on firm rib all the way round, not inside the dip
- nothing presses on your throat, belly or breasts, and no nipple is the centre of pressure
- after pumping, the bell sticks by itself
- you feel the pull, but no painful discomfort
If it fails, stop. Don’t pump harder to force a seal, because Klobe warns against unnecessarily strong vacuum. Chest hair can break the seal too (he says keep it short), so rule that out first. Then photograph how the bell sits and contact the maker inside its window. For the full routine, see my guide on how to use a vacuum bell.
If you’re not sure a bell suits your chest at all, start with my free 1-minute pectus quiz. The right size gets the rim onto your ribs. It doesn’t do the wearing for you.
Sources
- Klobe E. Trichterbrustversorgung mit der Saugglocke nach Eckart Klobe (the inventor’s own article). Orthopädie Technik. 2019;(1), English special edition. Read it
- Klobe E. The Eckart Klobe Vacuum Bell for Non-Invasive Lifting of Funnel Chest: Instructions for use (the inventor’s instructions for his own bell). 2010 Nov 3. Read it
- Vacuum Bell Size Guide: How to Choose the Right One. Ventura Medical Technologies. 2026 Jan 13. [cited 2026 Oct 20]. Read it
- Haecker FM, Sesia S. Vacuum bell therapy. Ann Cardiothorac Surg. 2016;5(5):440-9. Read it
- Haecker FM. 20 years clinical application of the vacuum bell for conservative treatment of pectus excavatum: past, present, future. J Thorac Dis. 2024;16(8):5285-98. Read it
- Loufopoulos I, Karagiannidis IG, Lampridis S, Mitsos S, Panagiotopoulos N. Vacuum Bell: Is It a Useful Innovative Device for Pectus Excavatum Correction? Turk Thorac J. 2021;22(3):251-6. Read it
- Vacuum Bell Treatment for Pectus Excavatum. Cincinnati Children’s. Updated 2026 Jun. [cited 2026 Oct 20]. Read it
- Model Size Consultation. Pectus Healing. [cited 2026 Oct 20]. Read it
- Vacuum Bell Perimeters. Pectus Healing. [cited 2026 Oct 20]. Read it
- FormaChest Vacuum Bell. FormaChest (AUGUMENTUM SRL). [cited 2026 Oct 20]. Read it
- Vacuum Bell for Pectus Excavatum. Pectus Solutions. [cited 2026 Oct 20]. Read it
- Pectus Excavatum Vacuum Bell. Pectus International. [cited 2026 Oct 20]. Read it
- Gvacuum Pectus Excavatum Vacuum Bell. Pectus Lab. [cited 2026 Oct 20]. Read it
- Does Vacuum Bell Size Matter for Pectus Excavatum? Pectus Lab. 2026 Jul 21. [cited 2026 Oct 20]. Read it
A bell sized to your chest and depth, with the session length and suction progression that decide whether it works.
- Cup sized to your chest, not a size chart
- Session length and pressure progression
- How to tell at 8 weeks if you are responding
This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any treatment plan. View full disclaimer →
