Can I Augment My Right Subcostal Ribcage Due To Asymmetry?
Q: Dr. Eppley, I have a theoretical question about a subcostal rib cage implant for one side of my body. I was born with underdeveloped and thinner ribs on one side of my body (a rare variation of poland syndrome). IT is not from anything, they are actually thinner on my right side as my chest too with even strength on both sides is very unequal in thickness no matter what I do. I could get rib shaving on the other thicker rib cage to even it out, but the problem is my hips are too bulky for that. Because of this underdeveloped rib cage, my right side abs don’t really go out in front of the hip or level making the hip look really bad and buldgy and my abs aren’t at the same level which looks really off. ISS there any implant (Im assuming a rib one) that could be made that would push those right rectus abdominal muscles a bit further out to match the other side? Also this unevenness in my rib cage is also present in my chest thickness (Going to have an implant in my right chest to help feel straighter because I always feel crooked) but could the same thing be done with the rib cage below the chest? I can’t find a good picture that depicts the uneven level of the abs but it is very apparent visually.
A: Thank you for your inquiry and detailing your body contouring needs. What you have described is very possible because the subcostal rib cage is largely covered by the upper portion of the rectus abdomins muscle. This provides the opportunity to place an implant on top of the ribs but under the muscle which would do, just as you have described, push out the right rectus abdominus muscle. Not only would this create that effect but also places the implant in the most favorable location. (submuscular location)
Whether the same concept applies to higher up on the chest requires a better understanding of the actual chest wall deformity as well as where that is location compared to the pectoralis major muscle attachments.
Dr. Barry Eppley