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Progression of pectus excavatum and carinatum coincides with adolescence, a critical period for identity and self-esteem development. While clinical decision-making and insurance coverage have historically emphasized anatomic severity and cardiopulmonary functioning, increasing evidence suggests that psychosocial burden and quality of life (QoL) impairment represent central components of disease impact. A narrative review was conducted using the PubMed database to synthesize the current literature on the psychological impact of these deformities in adolescents and young adults, including body image distress, social functioning, and mental health effects before and after surgical and non-surgical correction, focusing on validated tools and qualitative studies. Across multiple cohorts, adolescents and young adults with chest wall deformities consistently report impaired body image, reduced self-esteem, social avoidance, and diminished QoL, even in the absence of diagnosable psychiatric disorders. Surgical and non-surgical corrections have positive effects in these domains. Psychological burden, therefore, represents a clinically meaningful component of chest wall deformities and should be considered alongside anatomic and physiologic criteria. Current evidence advocates for the integration of standardized psychosocial screening and support into evaluation and follow-up, which is essential for providing comprehensive, patient-centered care. Greater recognition of psychosocial outcomes may inform advocacy for broader treatment criteria, increasing accessibility among affected individuals.