Am I A Good Candidate For Rib Remodeling After Losing 100lbs?

Q: Dr. Eppley, Hello! Im considering rib remodeling but you offer rib reshaping. How do I get a consultation thank you! My problem is I have flared rib cage. I may need a reversed tummy tuck as well to adress the mid line skin laxity  Im after extended tummy tuck and muscle repair after losing 105 lbs.

A:Thank you for your inquiry and sending all of your before and after pictures. First I would like to heavily congratulate you and your surgeon on what really is a spectacular result from where you have started. You could not have hope for a better outcome than what you have achieved. That being said as you’re now look to try to improve upon this initial spectacular result further improvements are going to start to more carefully look at the benefit to risk ratio. What I mean by that specifically is there going to be some more visible aesthetic trade-offs as you are try to improve upon this result.

From a tummy tuck standpoint it is important to remember that the commonly performed abdominoplasty/panniculectomy is a horizontal excisional based operation. It is not a 3-D excision. Meaning it cannot adequately address the vertical dimension of the skin excess unless one had an original fleur-de-lis type tummy tuck which you did not. A reverse tummy tuck is not going to help you as that is another horizontally based excision with a higher scar line under the breasts. What do you really need is a vertical excision for the skin redundancy and to help pull the sides of the waistline i . While that is the anatomically correct dimensional change it is hard for me to imagine that most patients would consider a vertical scar line down the center of their abdomen as an acceptable trade-off. I certainly have seen patients do it but most of them do not look as good as you do after this operation.

As for the flared rib cage I would have similar concerns about the placement of subcostal scars given where you’re at now. If you should happen to have access to the subcostal rib area from a secondary vertical secondary tummy tuck that would be a different matter.

As you can see from the above descriptions you now have to be a lot more cautious and thoughtful about the choices you make as more visible scar lines are going to result from doing so.

Dr. Barry Eppley

World-Renowned Plastic Surgeon