Cosmetic Rib Reshaping
Q: Dr. Eppley, I would like to learn more about cosmetic rib reshaping. I am a 29 year old transgender woman, at 5’7″, 135 lb, with a 29.75″ waist and 36.25″ hips. I had fat grafting from my belly to my buttocks two years ago and consider the result a great improvement, but I am still unhappy with the protrusion of my ribs and my androgynous waist to hip ratio. I have attached pictures for your view and am wording whether rib removal surgery would be of benefit.
A: Thank you for sending your pictures for consideration for cosmetic rib reshaping surgery. Your waistline shape is a common issue amongst many male to female transgender patients. Your body frame from the frontal view maintains a straight line. In the goal of more feminine waistline it is almost always a need for a combination approach of reducing the horizontal waistline (creating a curved concavity) and adding some curves (convexities) in the hip//buttock region. For the concavity part this is where the role of rib removal has a place in thin body frames like yours. At the same time doing further liposuction of the abdomen, flanks and back and transferring what little fat there is to your hips would be a reasonable combination approach. Implants often have a role to play in the buttocks and hip regions but one final effort at fat grafting with rib removal would be a complete autologous approach to your body contouring efforts.
Dr. Barry Eppley