Thoracic deformities can exist alone, but in many cases, different types of deformities can be combined. This poses a problem for the surgery of the deformity. Of all the malformations, pectus excavatum is broadly characterized by an anterior projection of the chest wall, whereas funnel chest is concave. The pathogenesis of these two deformities is different, and it is difficult to imagine that both would be present in the same patient. However, in clinical practice we often encounter such patients. This indicates that there is some similarity in the pathogenesis of both. There are two cases of pectus excavatum combined with funnel chest, one of which is a partially anteriorly protruding pectus excavatum combined with a depressed funnel chest, and the other is a pigeon chest combined with a depressed lower chest wall. The first case is a typical compound deformity, while the second case can be called pigeon chest alone. When both deformities are present in combination, special demands are placed on the surgery. Neither alone nor a modified NUSS procedure can accomplish the correction and requires a special design based on the characteristics of the lesion. In patients with pigeon chest, the ideal surgery should elevate the depressed chest wall in addition to the sinking of the sternum in order to obtain a satisfactory result. In the other case, it is possible to perform the NUSS surgery with a partial depression of the anterior projection, or simply perform both the NUSS surgery and the modified NUSS pigeon chest surgery. This is a very effective surgical method.