Rib removal surgery can be an effective procedure for anatomic waistline reduction in properly selected patients. Such patients typically include the already thin female who is seeking an ‘extreme’ waistline reduction as well as the male to female transgender patient who is trying to achieve a more feminine waistline shape.
Rib removal is effective in either type patient because it removes an anatomic bony obstruction that then allows the soft tissues to collapse inward. It is only necessary to remove the outer half of the ribs that extend laterally beyond the outer border of the erector spinae muscle. The inner half of the rib remains intact as its medial end is still attached to the vertebral facets.
The procedure is done through incisions of about 4 cms in length that are obliquely placed in a skin crease that is made evident by turning at the waist. While the resolution of swelling and waist training can create an even greater change, the increased narrowing of the anatomic waistline can be appreciated even at one week after surgery.
Rib removal is a perfectly safe surgery contrary to the perception of many patients and even most surgeons. Since only a portion of the rib is removed and there is no real loss of structural support, it can be performed for purely aesthetic purposes.
Dr. Barry Eppley