Rib Removal Surgery

Q: Dr. Eppley, I am interested in rib removal surgery. I am a 44 year old transgender male to female that is struggling to obtain an hour glass figure.I have breast and buttock implants and was hoping to reduce my waist line. I run everyday and do abdominal trainings but I have the body I was born with and am trying to improve on it. It does not appear I am making much progress and I can’t get any thinner by diet and exercise.

A: What you struggling to achieve is to overcome the natural anatomic differences between the male an female ribcage. The actual number of ribs between males and females is actually the same despite the well known biblical citation …’The Lord God fashioned into a woman the rib which he had taken from the man…’ (Genesis 2:22) Both genders have 12 pairs of ribs although a few individuals have an extra rib or pair of them.

There are, however, some shape difference between them. The last pair of floating ribs in a female tend to be smaller in order to permit child bearing and is one reason women have a more narrow anatomic waistline. The other if not more important reason is that the arc or curve of the ribs in men is wider particularly in the lower half of the ribcage. This gives men a more ‘barrel effect’ of their torso and not that or a t=more tapering look as the level of the anatomic waistline.

Thus you are correct in that you are battling an anatomic difference that can not be changed by diet and exercise. You have really done all you can physically do. This is very common in transgender female and is one of my three types of patients who benefit by rib removal surgery. Removing ribs 11 and 12 combined with abdominal side wall liposuction all done from the prone position is the surgical step that will overcome this natural anatomic limitation.

Dr. Barry Eppley

Indianapolis, Indianapolis