Am I A Good Candidate for Rib Removal/Ribcage Narrowing?

Q: Dr. Eppley, I am a 26 year old female from who is looking to have rib removal done for ribcage narrowing. I saw online that you perform this surgery and was wondering if I would be a good candidate. My ribs have always bugged me because they protrude so much. I want them removed to create a smaller upper body and also because they stick out more than my breasts. I have attached some pictures of me laying down so you can see what I mean. I look forward to hearing from you.

A: Typically ribcage narrowing by rib removal is done to make one more ‘high-waisted’ or to lengthen the distance between the bottom of the ribcage and the hips. This is done by removing the cartilagious portions of ribs 9 and 10 which are more to the side of the ribcage. What you have/are demonstrating is rib protrusion or ribs that stick out. This involves the inner portion of the ribcage closer to the sternum rather than the side. This is a slightly different rib location. This is seen when one stands up but becomes a lot more noticeable when one lays down. (as seen in your picture) This protrusion occurs because of the confluence of ribs 6, 7 and 8. They all join in this area and the way they come together (angulation) causes them to stick out. This section of ribs can be removed (and is actually commonly done in reconstruction of microtia ears) but will require a 4 to 5 cm incision along the lower edge of the ribs to do it. This results in a fine line scar and one has to be certain that this is a good aesthetic trade-off.