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Ribcage Reshaping Osteotomies for Subcostal Rib Flare

Subcostal rib flare refers to the outward protrusion of the lower ribs, most commonly ribs 8–12, at or below the costal margin. It is primarily an osteocartilaginous issue, not a soft-tissue problem. Its key characteristics include: Visible outward angulation of the lower rib cage Most noticeable from: Frontal view (V-shaped or squared costal margin) Oblique Read More…

Custom Chin Implant Design Strategies To Minimize Labiomental Fold Deepening

Chin implants are notorious for causing a deepening effect on the labiomental fold. Does using a custom chin implant rather than an off-the-shelf design decrease that risk? The following is a fold-centric, design-specific discussion of custom chin implant strategies aimed at minimizing labiomental fold worsening. This assumes you’ve already decided an implant is appropriate and Read More…

Rib 11–12 (Type 1) vs Rib 10–12 (Type 2) Resection in Advanced Waist Contouring

Rib 11–12 vs Rib 10–12 Resection Advanced Waist Contouring — Indications, Impact, and Risk Escalation This comparison applies to advanced, carefully selected aesthetic cases. Rib 10 involvement changes the operation from flank refinement to structural waist narrowing. 1. Anatomical Importance Ribs 11–12 Both are floating ribs Influence the lower third of the waist No role Read More…

The Labiomental Fold in Chin Augmentation

The labiomental fold (the horizontal crease between the lower lip and the chin) is a critical anatomic and aesthetic consideration in chin augmentation, whether with implants, osteotomy, or fillers. Below is a structured, surgical-focused explanation. 1. Why the labiomental fold matters The depth and shape of the labiomental fold strongly influence: Lower facial balance Perceived chin projection Lip competence and Read More…

Rib 11 and 12 Removal Surgery

Resection of ribs 11 and 12, the freely floating ribs, are most commonly associated with aesthetic waist refinement. Because of their lack of a sternal attachment and their proximity to the waistline removal of their lateral projecting ends reduces the structural support of the sides of the waistline. Rib 11 is longer than rib 12 Read More…

Rib Removal Surgery – The 12th Rib

Rib 12 removal—also called 12th rib resection or floating rib excision—is a surgical procedure to partially or completely remove the 12th rib, the lowest rib in the rib cage. Because it does not attach to the sternum, it’s termed a floating rib. Aesthetic / body-contouring indications Waistline narrowing or flank contour refinement Typically partial resection Read More…

Custom MIdface Implant Thickness Design Guidelines By Sex

When creating custom facial implant designs there are two basic steps, creation of a footprint and determining the various  thicknesses of material throughout the implant’s footprint. By comparison the establishment of the the implant’s bony surface area coverage (footprint) is more visually apparent as the location. of the desired external effect usually correlates on a Read More…

Male and Female Custom MIdface Design Guidelines

Like all custom facial implants there are some learned guidelines  that help guide CAD design for both males and females. These rules apply regardless of the material  used. MALE Custom Midface Implant Design Rules 1. Lateral projection > anterior projection Drive augmentation outward along the zygomatic arch Keep anterior cheek relatively flat Think horizontal vector, Read More…

Male vs Female Custom MIdface Implant Strategies

Male and female midface implant strategies differ less by implant type and more by shape, vector, and projection philosophy. The goal is to reinforce sex-specific skeletal cues rather than simply “add volume.” Core Aesthetic Differences Feature Male Strategy Female Strategy Dominant cue Structure & angularity Soft contour & curvature Projection emphasis Lateral / horizontal Anterior Read More…

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