Can Rib Removal Be Done Without A Tummy Tuck?

Q: Dr. Eppley, I am a very tiny 28 year old who is constantly mistaken for being 15. I have a 32AA cup size, and my torso goes straight up and down with no curves. My hips do not curve out more than my waist. In addition, I am also 5ft tall so my ribs are only about 3/4 of an inch above my iliac crest. Because of this, I believe I have no inward curve of my waist. Rather than implanting silicone to fill my bust, I feel I would be more confident with a rib removal to enhance a curve and make my waist skinnier than my hips. I do not believe I need a tummy tuck. I have a tiny bit of fat on my rectus abdominus, external obliques, and lower back combined. But my waist circumference is 29 and my hips are 33. I only weigh 103 lbs while I am 5ft0in tall so I do not have a lot of fat. My stomach does protrude past my flat chest into a bit of what looks like bloating, but I always have this shape. I have visible abdominal muscles below my tiny bit of fat, which is why I don’t think I would need a tummy tuck.

Two questions: 

1) Do you think rib removal without a tummy tuck would give me more of a womanly shape (smaller waist to hip ratio)? Where would the scars be and how big without a tummy tuck?

2) Do you think I am chronically bloated or store more fat internally (greater omentum) rather than on top of my abs? Like I said I am only 103 lbs, 5ft. 29 inch waist and 33inch hips. but my stomach protrudes almost looking like I am 3 months pregnant perhaps. I have also been told by my parents that this “protruded stomach body shape” runs in the family and is thought to be Lordosis. Could this really be the case?

A: Thank you for your inquiry and providing the details of your body shape and objectives to which I can make the following comments:

1) Rib removal for horizontal waistline reduction is done through small (4.5 cms) oblique back incisions and removes ribs #11 and 12 and usually #10 as well. This is never performed through a tummy tuck as these ribs are not reachable from that anterior approach.

2) The type of rib removals done through a tummy tuck approach are the anterior subcostal rib cage margins of ribs #7, 8 and 9 and is done for subcostal rib protrusions not horizontal waistline reduction.

3) Very thin and petite women are one of the major patient groups that seek out rib removal surgery for the exact reasons you have described….to provide some inward curve to an otherwise straight torso.

4) Being thin and virtually having no breast tissue, even low weight females can have a pseudo abdominal pooch. It would be exacerbated by a lordotic condition for sure. Whether that applies to you I can say since I do not know what your body exactly looks like.

Dr. Barry Eppley

Indianapolis, Indiana