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Back Lift Orientation and Rib Removal: Surgical Strategy and Aesthetic Impact

When rib removal (most commonly the 11th and 12th floating ribs) is combined with a back lift, the orientation of the excision—horizontal versus vertical—is the dominant factor determining the quality of waist narrowing, scar placement, and overall contour change. 1. Horizontal Back Lift With Rib Removal Incision Transverse excision across the mid- to upper back, Read More…

Rib 9 Osteotomy Technique for Ribcage Narrowing

In rib removal surgery for waist modification, the free-floating 11th and 12th ribs have historically been the primary targets. This preference is due to their relative accessibility and lack of distal structural attachments. However, more recent surgical experience and anatomical analysis have demonstrated that ribs 10 and 11 possess longer and wider segments than rib Read More…

Surgical Techniques in Standard Rib Removal Surgery

Rib removal surgery typically refers to partial resection of the floating ribs (11th and/or 12th ribs) and sometimes the 10th rib to reduce lower waist width or to improve contour.  In aesthetic surgery patient selection it is highly selective. Common Indications Aesthetic Lower waist narrowing when skeletal width is dominant Adjunct to abdominoplasty, liposuction, or Read More…

Hollow-Chamber Testicle Implants: Overview

Hollow-chamber testicle implants are a specialized implant design developed to address two distinct clinical goals, depending on the size and function of the internal chamber. What They Are Constructed from a silicone elastomer shell Contain an internal hollow chamber, which varies in size based on intended use There are two primary designs: Small-Chamber Hollow Implant Read More…

Custom Pectoral Implant Design and Replacement – Case Study and Revision Considerations

Introduction Custom pectoral implants are patient-specific chest implants designed to enhance or restore the size, shape, and symmetry of the pectoral region. They are most commonly used in men seeking a more defined, athletic chest or correction of congenital or acquired asymmetry. Benefits of Custom Implant Design for Pectoral Augmentation CT-based design and preoperative controlThree-dimensional Read More…

Occipital Bun Reduction with Scalp Roll Excision Case Study

Introduction An occipital bun is a rounded overgrowth of the occipital bone at the back of the skull. This produces an exaggerated posterior curvature that disrupts the normal, smooth convex contour of the back of the head when viewed in profile. It represents a normal anatomic variant of skull development rather than a true bony Read More…

Custom Brow Bone Implant Design Options

Brow bone implant designs are customized based on how much projection, width, and shape are needed along the lower forehead and eye area. Based on my extensive custom facial implant experience there are numerous design patterns that patients have needed for specific aesthetic enhancements. These various designs are based on differing brow bone anatomic zones. Read More…

Custom Brow Bone Feminization Reversal -Case Study

Introduction A custom brow bone implant is a patient-specific facial implant designed to enhance or reconstruct the supraorbital rims (brow ridges). Aesthetically, it is most commonly used for facial masculinization or for correction of flat or recessed brows. With the growing popularity of facial feminization surgery (FFS), custom brow bone implants have also become an Read More…

Design Guidelines for Custom Square Chin Implants for Men

While some men that request custom chin implants may not desire a more square chin appearance, many do.Here are some surgeon-experienced  guidelines for designing a custom square chin implant (male or masculinizing focus). 1. Aesthetic Objectives (Square ? Wide) Primary goal: angularity and vertical definition, not excessive transverse width. Emphasize a flat or gently convex Read More…

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