Rib remodeling, also known as rib contouring or rib reduction, is unlike traditional plastic surgery procedures because it focuses on enhancing the patient’s structural anatomy rather than simply addressing skin and fat.
The waistline is defined superiorly by the lower ribs and inferiorly by the pelvic bone. Traditionally, techniques to narrow the waistline included liposuction to remove excess fat, muscle tightening procedures such as the corset in the abdominoplasty, and excess skin removal. The bony structures were left mostly untouched and that was the limit of our armamentarium.
In the past few decades, plastic surgeons have pushed the boundaries of what is able to be modified. Dr. Kutzaev from Russia described the rib corticotomy (controlled fracturing) for waist narrowing. Rib resection or removal has been described by many authors. Remodeling can also be achieved through controlled fracturing and plate fixation at a defined angle, a technique called Riboss (Aguilar, Colombia). Daniel and Carlos Oñate from Ecuador have popularized a minimally invasive technique of controlled rib fracturing on ribs 10, 11, and 12 though an incision smaller than 1 centimeter. The anatomy is studied through a 3D CT of the thorax. The procedure is carried out under general anesthesia by itself or with other procedures like liposuction. The patient recuperates with the use of a corset for a two-month period.
The combination of soft tissue and bony techniques have allowed plastic surgeons to further aesthetic expectations in body contouring. During your consult, Dr. Salama will go over the procedure in detail and answer any questions you may have.