<p>Advances in three-dimensional imaging, computer-aided design, and custom implant fabrication have broadened reconstructive options for patients with chest wall deformities. Those technologies enable increasingly precise, patient-specific morphological planning and have expanded the role of implant-based reconstruction alongside traditional thoracic remodeling procedures. However, the current literature remains highly heterogeneous and methodologically limited, precluding definitive conclusions regarding the superiority of any single surgical strategy. Across reported series, objective functional impairment is often limited or variable, whereas the psychosocial burden and visible morphological abnormality may represent the dominant drivers of treatment seeking. Given the potential morbidity associated with invasive skeletal correction, careful preoperative evaluation is essential to distinguish physiological compromise from predominantly cosmetic or morphological concerns and to determine whether cardiopulmonary findings justify thoracic remodeling. In selected patients with demonstrable functional limitation or severe structural distortion, skeletal reconstruction remains appropriate, while in others, digitally planned, patient-specific implant-based approaches may provide effective morphological correction with reduced invasiveness. Overall, available evidence supports an individualized treatment paradigm guided by anatomical characteristics, objective functional assessment, and patient-defined goals rather than a uniform corrective approach. There is a strong need for higher-quality comparative studies to inform future clinical decision-making.</p><p>Level of Evidence: Not gradable.</p>