Can The Rib Fracture Technique Be Used On Ribs #8 and #9?

Q: Dr. Eppley, I have a question. A different procedure I’m interested in is rib remodeling as opposed to rib removal. I believe it is known colloquially as ribxcar. I’m specifically interested in going up to the 8th rib, but I know this requires expertise with this kind of procedure. Does Dr. Eppley perform this kind of procedure, or does he only do rib removal? 

A:I have performed both rib removal and rib fracture techniques although by far most people come to me for the rib removal method. The rib fracture method is a simpler technique that relies heavily on months of postoperative compression to achieve its effects. I have not found the rib fracture method to have less of a recovery and and in some cases the recovery is more painful with fracturing than removal. Rib fracturing requires the bone to heal and develop bony consolidation while rib removal involves soft tissue (muscle) recovery and not bone.

The rib fracture technique only applies to ribs 10, 11 and 12 because they have unattached ends. Fracturing ribs 8 and 9 will be of no benefit since they have stable front and back attachments and thus are not capable of collapsing by being fractured. Regardless of the rib method used ribs 8 and 9 need to have a bone section removed and then the two ends put together with plates and screws to achieve any narrowing reduction.

Dr. Barry Eppley

World-Renowned Plastic Surgeon