What Is The Difference Between Rib Removal and RibXcar?

Q: Dr. Eppley, I’m still struggling with the same developmental dysphoria we discussed back then, and I’ve been researching newer rib-remodeling techniques such as RibXCAR and RibBOSS. Before I make any decisions, I would really value Dr. Eppley’s perspective, given his expertise with rib contouring and fixation techniques.

A: To best understand the differences between Rib Removal and RibXcar you need to read my summary on the differences as listed below

Introduction

Waistline narrowing can be accomplished by a variety of well known soft tissue procedures. Liposuction and tummy tucks (abdominoplasty) are the two main surgical procedures  used with emphasis on wide fascial plication techniques to maximize the waistline narrowing effect. Rib modification, or structural waistline narrowing, is a more recent type of procedure that is far less known and practiced. They are, however, beginning to emerge as another option to maximize waistline reduction in the properly selected patient.

Surgical rib modification for waistline narrowing is divided into two types of procedures, removal (excision) and contouring (bending). They differences are:

RIB REMOVAL (Rib Resection)

A  surgical procedure where the lower “floating” ribs (usually 11 and 12,and occasionally 10) undergo subtotal removal (outer prominences). With some surgeons reduction of the outer edge of the latissimus dorsi muscle may also be done.

Benefits

• Maximal narrowing of the waist
• Structural removal of the lateral rib prominences and overlying muscle
• Permanent change to the lower ribcage
• Minimally patient dependent (limited garment use)

Disadvantages

• More Invasive surgery with the creation of small incisional scars
• Short tern drain use
• Risk of postoperative seroma(fluid collection0
• Risk of nerve pain or prolonged soreness

RIB Xcar (Minimally Invasive Rib Contouring)

A technique developed for reducing the flare of  the lower ribcage without removing ribs. Using a percutaneous technique ribs 10, 11 and 12 are partially cut by a pieziotome and fractured.

Benefits

• Less invasive with a quicker recovery for most patients.
• Good complement to other body controlling procedures

Disadvantages

• Dependent on strict patient compliance with postoperative garment wear for three months after surgery
• Increased risks of pneumothorax (due to blind cutting and fracturing of the bone)
• Not ideal for patients seeking maximal waist reduction as an isolated procedure.

Side-by-Side Comparison

In the end it comes to understanding that the success in Rib Xcar is highkly dependent on 3 months of corset wear. If this is not done in a consistent basis the operartion does not work.

Dr. Barry Eppley

World-Renowned Plastic Surgeon