Rib Removal/Remodeling

Female with right subcostal rib flare and left subcostal rib deformity protrusion. 3D CT scan shows severe hypoplasia of bilateral ribs #12 and left subcostal twisted/bent rib deformity.

Bilateral subcostal rib surgery with left excision, shaving and cartilage cuts and right medial and lateral cartilage cuts.

Thin female desiring waistline narrowing. Preop 3D CT showed congenital absence of left ribs #12

Waistline narrowing by bilateral flank liposuction and subtotal removal of left ribs 10, 11 and 12 and right rib 10 and 11

Female desiring larger buttocks and smaller waistline.

Placement of bilateral intramuscular buttock implants with removal of ribs #11 and #12 with some LD muscle.

Desire for correction of left subcostal rib flare.

Shaving of left rib #8 to reduce flare through small overlying incision. (Which is marked in red with the purple being the extent of the flare)

Transfemale forlower torso narrowing.

Lateral or Type 2 rib removals with removal of outer halfs of ribs 10 and #11 , burring/thjinning of rib #9 and removal of a long strip of latissimus dorsi muscle.

Patients who corset often. seek rib removal as a method of achieving a permanent change that does not require the use of a corset.

Six rib removals (10,11 and 12) through small oblique back incisions.

Desire for subcostal ribcage protrusion reduction at the same time as a tummy tuck.

During a full tummy tuck the subcostal ribs (8, 9,and 10) can be accessed for removal (ribs #9 and 10) and shaving (rib #8).

Desire for reduction of abdominal fat and subcostal protrusions.

Abdominal liposuction combined with direct subcostal rib resections. (ribs #9mand 10)

Patient with painful slipped rib #11.

Direct removal of slipped rib#11 with Exparel-soaked gel foam in the rib space for postoperative pain control.

Female desiring waistline narrowing

Waistline narrowing with flank liposuction, removal of the outer ribs #11 and #12 and LD muscle strip removal.

Desire for reduction of right subcostal rib protrusion/asymmetry.

Removal of cartilaginous portions of right ribs #9 and #10 by direct excision for protrusion reduction. Due to the calcified nature of the cartilages small pieces had to be removed in a meticulous manner.

Desire improved lower torso shape. Is 5'10" tall and weights 137lbs.

Type 2 rib removal procedure with subtotal removal of ribs #10 11 and 12 through a vertical lateral incision. Results are one year postop.

Desire for subcostal rib protrusion reduction at the same time as a tummy tuck.

Anterior subcostal cartilaginous rib removal of #8 and #9 done at the same time and through a tummy tuck approach.

Thin female desiring a more visible waistline and much larger and rounder breast implants.

Combined subtotal rib removals (10,11 and 12) with breast implant replacements.

Female desiring maximal waistline reduction/narrowing.

Subtotal rib removals of 10, 11 and 12 with outer shave of the latissimus dorsi muscle for waistline narrowing effect.

Female athlete (body builder) desiring a smaller waist.

Rib removal of 11 and 12 with latissimus dorsi muscle reduction. (with no adverse muscle effects afterward)

Desire to reduce prominent subcostal rib margins.

Direct approach to subcostal rib shaves of # 8 and #9 ribs

Female desiring waistline reduction by structural changes.

Type 1 rib removal surgery, the most common technique done in cis-females, involves an oblique back incision with the removal of the outer third of ribs #11 and #12, removal of a bony section of rib #10, a wedge of LD back muscle and flank liposuction if needed.

Thick muscular torso from previous powerlifter who desired waistline reduction/narrowing surgery. Thicker tissue patients are challenging to see effective changes and maximum approach is needed.

Waistline reduction surgery including flank liposuction, subtotal removal of ribs #10, 11 and 12 and latissimus dorsi muscle reduction. (5 days postop)

Desire for increased waistline definition with a more boxy torso shape.

Subtotal removal of ribs 11 and 12 with LD muscle modification through an oblique 4 com back incisions.

Female with prior scoliosis surgery who desired a more defined waistline.

The use of her existing midline back scar from her scoliosis surgery was desired to be used but it was unclear certain beforehand it is could be done. Thus the typical lower oblique back incisions were marked. During surgery there was no problem accessing the ribs through the latissimus dorsi muscle. Ribs #10 and #11 could be removed (subtotal) and the small ends of #12 were also removed. The back skin was also tightened by scar excision like a mini- vertical back lift.

Bikini bodybuilder enthusiast who desired a more narrow waistline as well as ribcage asymmetry improvement from her congenital scoliosis.

Type 2 rib procedure with subtotal removal is ribs #10, 11 and 12 as well as LD muscle modification. The immediate intraoperative view shows the improvement in the right side ribcage protrusion from the scoliosis. How significant the waist narrowing will be awaits several months of healing.

Female bodybuilder who desired a more narrow waist to accentuate her upper torso size.

Type 1 rib removals seen four years later with the addition of PMMA filler injections to her buttocks.

Thin petite female desiring maximal waistline reduction, elimination of rib 10 subcostal protrusions and bony hip flare reduction.

Subtotal removal of ribs 10, 11 and 12 with iliac crest bony reductions.

Desire for removal of prominent subcostal rib protrusions.

Direct resection of prominent subcostal rib margins with abdominal liposuction.

Desire for waist/torso narrowing.

Subtotal rib removals (10,11,12), rib #9 osteotomy shortening, rib 8 shaving with LD muscle resection.

Small female desiring some waistline shape to her straight torso silhouette.

Subtotal rib removal 10, 11 and 12 through small flank incisions.

Desire for reduction of subcostal ribcage flare.

Open excision of subcostal rib flare with partial removal of they cartilaginous ends of ribs 9 and 10 and sagging of rib 8.

Desire for waist/torso narrowing

Torso narrowing accomplished by subtotal removal of ribs 10, 11 and 12 along with shortening osteotomies of ribs 8 and 9. In addition long strips of LD muscle were also removed and plicated inward.

Thin petite female desiring an even smaller waist than the one he already had. In addition she also wanted reduction in her prominent hips (iliac crests)

Rib removals (10,11 and 12) with bony iliac crest reductions.

Type 2 rib removal procedure with subtotal reduction of ribs 10, 11 and 12 as well as LD resection and plication.

Three month postoperative result.