Q: Dr. Eppley, I am interested in rib removal. I’m a thin girl, and I was considering removing four ribs to get a smaller waist. My plastic surgeon in my hometown said he punctured a lung while performing this surgery before and therefore does not do this procedure anymore. Is there anyway to eliminate this risk? Any other major risks and complications with this surgery? Can it be done under local with IV sedation instead of general anesthesia? Thank you for your time.
A: The best way to avoid such a complication as you have described for rib removal surgery is to have someone do it that knows what they are doing. That should be a complication that is easily avoided in experienced hands, particularly down as low as ribs #11 and #12 where the base of the lung does not extend that low. This is a procedure that can only be done under general anesthesia. It is performed in the prone position (with the patient face down) and Exparel long-acting local anesthetic is used for nerve blocks once the rib portions are removed. This is a very safe procedure when down by a surgeon with experience doing it.
Dr. Barry Eppley