Male to Female Transgender Rib Removal Surgery for Waistline Reduction
Q: Dr. Eppley, I have questions about rib removal surgery. I’m a MtF transgender and have a very hard time narrowing my waist. This gives (in my opinion) a very masculine appearance to my body. I was wondering how much a rib removal is, how dramatic you think it can be in a transgender patient, and if it would be enough to give a feminine appearance to the ribcage, or if corsetting would still be required for a “tapered” look. I’m looking for something drastic in my body, but something that still seems natural for a woman if that makes any sense.
I’d also be interested in any before and after that may be available for transgender patients that have had this procedure, if there are any available!
A: About 1/3 of the patients in which I perform rib removal for horizontal waistline reduction are MtF transgender patients. They seek the procedure out for the exact same reasons to which you have described. Because of their genetic male ribcage and torso shape there is no other effective alternative. Removal of the lower half of ribs #10, 11 and 12 (as well as a wedge of latissimus dorsi muscle) removes an anatomic barrier for whatever maximal waistline reduction is possible. The degree of such waistline change is open to personal interpretation as to what constitutes ‘drastic’. Noticeable is what I could call it but I would never use the term ’drastic’ as that implies an unrealistic surgical expectation. I have never had a transgender patient, or any rib removal patient for that matter, complain afterwards that the result was inadequate…but I know why. This is all that can be done for waistline narrowing, there no other alternatives so whatever the result is is the best that can be achieved.
A period of postoperative corseting is always helpful as the compression helps with swelling and the shaping of the waistline. But I do not see it as a necessary permanent waistline shaping method to do.
Dr. Barry Eppley