If I Have Rib Removal For Waist Narrowing Would I Be Able To Have A Rib Graft Rhinoplasty In The Future?

Q: Dr. Eppley, I have attached two photos for reference. I’m looking to have the extra skin removed which I’m not sure is visible in the photo. You can also see some horizontal stretch marks which I was wondering would be covered up during the vertical back lift. 

My plan in the next few months is to have lipo on my stomach which may also create more loose skin on my back based on what I’ve been reading (of course results may vary). I don’t have a definitive date booked yet as I had to reschedule my original date due to personal circumstances. I haven’t had excess weight loss but my goal is to find a way to tighten the skin on my bra line as I have issues wearing certain clothing. My surgeon who is performing lipo on my stomach advised me that lipo is not recommended and that I’d have to look consider a bra lift if I wanted to achieve my goals as lipo would not give me my desired results.

Do you also perform rib removal and is this recommended for waist reduction? Will this decrease any chance for rhinoplasty revision in the future as I understand ribs are sometimes used for rhinoplasty revisions? (I like to keep my options open.) Do you think this surgery is recommended for what I’m looking to achieve or are there other recommendations? Am I a good candidate?

In terms of the rhinoplasty I’ve been reading that, based on my goals, a tip plasty and alar plasty are less invasive and more likely to be the way to go for what I wish to achieve (narrowing of nostrils and more refined tip). I also understand that the tip sometimes does require support so I will leave this recommendation up to you.

I look forward to hearing your feedback and thoughts.

A:Thank you for your inquiry and sending your pictures. Your surgeon is correct in that light perception of the back is not a successful approach for managing your redundant tissue issues. Neither would a traditional bra lift be successful either as a horizontal excision is not the direction in which your redundant tissue lies. The vertical backlift is a better orientation for your tissue excision as seen in the attached Image. Whether one chooses to have ribs removed and the LD muscle narrowed as part of a vertical bralift is based on whether one wants waistline reduction at the same time. That is a personal choice.

In regards to the nose I cannot comment on what your reshaping needs are as I have not seen any pictures of your face. The only general statement I can make is, while rib cartilage is sometimes needed for rhinoplasty, rib removal is largely bone and is not useful for rhinoplasty surgery. Therefore rib removal surgery does not compromise any future graft needs for rhinoplasty surgery.

Dr. Barry Eppley

World-Renowned Plastic Surgeon