There are a variety of aesthetic ribcage modification procedures that are not well known. When people speak of ‘rib removal’ this is commonly perceived as a procedure for waistline reduction through removal of portions of ribs #11 and 12. (and sometimes #10) While this is certainly true this is not the only rib removal procedure done for aesthetic body contouring benefits.
Another type of rib removal is that of the ‘rib shave’. This is technique that is used almost exclusively on the anterior ribs along the subcostal margin. The subcostal rib area is composed of ribs #7, #8 and #9 and makes up the bottom of the curved ribcage at the upper abdominal region. In some individuals the subcostal rib may protrude out in an abnormal fashion. When present this often occurs only one side creating an obvious asymmetry.
Reduction of a prominent subcostal margin can be done by either rib removal or a rib shave. Which approach is most appropriate depends the amount and location of the subcostal protrusion. The more medial (closer to the sternum) the protrusion is or the minor that it is a rib shave is usually most effective. The more lateral or larger the subcostal protusion is then removal of portions of ribs #8 and #9 may be needed. In some cases of subcostal protrusions a combination of rib removal and rib shave may be needed.
In a rib shave a very small subcostal incision (3 cms) can be used right along the prominent area. Once through the rectus muscle by a splitting technique the subcostal rib margin is easily accessed for modification.
Dr. Barry Eppley
Indianapolis, Indiana