Q: Dr. Eppley, I’ve been looking up videos and articles about your most well known rib removal surgery patient just for entertainment. It must get frustrating having to deal with so much misunderstanding and arrogance among people who couldn’t perform such a difficult procedure, and knowing there’s many doctors who do it privately. I just wanted to thank you again for making my life a little easier by not having to worry about corset training. I know I’m still in the recovery stage but I’m usually in a recovery stage these past few years. I have a general question, how often do you do rib removals a year?
A: There is no question that there remains a lot of ‘mystery’ and misconceptions about rib removal surgery, particularly amongst surgeons who often view it as dangerous and ill advised. (of course they have never actually done the operation or ever taken even a single rib for any purpose) Having done it many times over the years I have a unique perspective on it and its outcome and value to patients. In each and every case I have done, patients have had satisfactory outcomes and no complications. That is all the vindication that I need that the surgery is both safe and effective in the properly selected patient.
What used to be a procedure that was done once or twice a year is becoming a procedure that I now do about once a month. As the public becomes more aware of it and the procedure comes out of ‘hiding’, more patients are interested in having it done.
Dr. Barry Eppley
Q: Dr. Eppley, I’m interested about rib removal surgery for a smaller waistline. What are the qualifications for this type of body contouring surgery. mIf I qualify, how long will I stay in the hospital? When can I get back to work? My work requires a lot of standing and some walking. Thanks a lot 🙂
A: Rib removal surgery is best done in patients that have a reasonably thin body frame (not lot of fat around the waistline) in which the anatomic waistline is not well-defined. It is also important that liposuction of the abdomen and waistline will not help to create the more defined wasitline and that the ‘obstruction’ is caused by the flare of the lower ribcage.
For most patients, rib removal surgery can be performed as an outpatient if you have someone to take you from the surgery center and be with you. (the procedure is done in a surgery center not a hospital) If not, then it will be an overnight stay. One can return to work when one feels capable. That will vary amongst different people and could be anywhere from 10 days to three weeks for a semi-strenuous type of work. One can not hurt the surgery sites by anything that they physically do.
Dr. Barry Eppley
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
Q: Dr. Eppley, I am jnterested in rib removal surgery.I will like to slim my waist. I’m a bikini fitness competitor and my waist is very width. Off season (photo) I have 70 cm, in season I have 67 cm. I don’t know is there is another procedure that can help me slim my waist. I have been researching about ribs removal and I want to know how much time I could not exercise. And the most important question is how much could I slim my waist?
A: Given your picture I would agree that I don’t see anything else you could do on your own to narrow your waist any further. I suspect rib removal surgery could probably achieve a waistline reduction down to 62 to 64 cm in circumference . Time off from exercise would be totally dependent on how you feel but would most definitely be two to three weeks. There are no restrictions after surgery. You let your body tell you when to do any physical activities.
Rib removal surgery does leave a fine line scar as a residue from the procedure. So one has to be certain that aesthetic trade-off is a worthwhile one for the amount of waistline reduction seen.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in rib removal surgery. How many ribs can a patient have removed all together? I’ve read about your procedure and I would like more ribs removed, rather than just: 10, 11, or 12. I have very strong, prominent, wide ribs that I no longer wish to have. Wearing tight jackets and tight tops make my appearance look much worst. Can you remove more ribs than just these six? What is the cost of this surgery??
A: The main purpose of rib removal surgery in most cases is to narrow the waistline. Ribs #10, 11 , and 12 are the only ones that have any impact on the anatomic waist. Further rib removal (#8 and #9) will not change the shape of the waistline. In addition while the cartilaginous portions of ribs #8 and #9 can be removed, they require a different incisional approach to remove which is either done by a direct incision over them or through a tummy tuck incision.
I would need to see pictures of your torso and for you to point out the ribs that you see as a problem. But rib removal surgery is limited to the lower end of the ribcage with an emphasis on making the anatomic waistline more defined…which is about at the level of the belly button.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in rib removal surgery. I want a slimmer waist. It’s something I can’t achieve with working out unfortunately. The more I work out the more boy like my body becomes. I look more feminine in my body shape when I work out less because when I burn fat my body becomes very straight. I have narrow hips and a small butt. I don’t have much fat on my belly so I know that is not the issue. My body shape is just very straight. I would like to have a more curvy body (I am also considering butt implants but that is an entirely different procedure). I don’t know how many ribs would be needed to take out in order to achieve what I want. I am not obsessed with a slim waist line I would simply like to narrow it somewhat. I think I would need your guidance to know how many and what I can achieve. I don’t want anything that would look unnatural, and I don’t want to risk my health. Being able to work out is important to me and I don’t want to be limited in any way. I don’t want to look like a Barbie, I simply want a enhancement to my body, to look more attractive and more feminine. Please suggest. Thank you and looking forward to your reply.
A: For your very straight torso, waistline narrowing by rib removal would likely be effective. Rib removal surgery of at least #s 11 and 12 would be needed and possibly a part of #10 as well. This is both safe, does not preclude working out afterwards and produces a very visible indentation at the anatomic waistline level. Since this type of rib removal surgery is done in the prone position, one may consider concurrent buttock implant surgery as well since that also has to be done in the prone position and any amount of buttock augmentation would contribute to your overall more curvy body as well.
Dr. Barry Eppley