Background: The shape of one’s waistline is influenced by a variety of tissue elements. These consist from the outside inward the skin, subcutaneous fat, multiple muscle layers, bony ribs and the size of the intra-abdominal space. Surgical manipulation can be done all of them with the exception of the intra-abdominal space and organs.
Rb removal surgery for waistline narrowing is really a combination of three procedures which focus on manipulation of the intermediate layers of the waistline including subcutaneous fat, latissimus dorsi muscle and the ribs. Removing portions of all three will make some reduction of the circumferential waistline, the only question is how much. Will it be enough to justify the surgical effort?
Case Study: This female has a prior BBL surgery with a 27inch waist. She desired even further reduction and was prepared to undergo the ‘ultimate’ procedure to do so.
Under general anesthesia and in the prone position, the distal half of ribs #11 and 12 were removed as a piece of rib #10 which allows the wrap around rib to collapse inward. A wedge of latissimus dorsi muscle from each side was also removed.
When seen four years later (for other procedures) she reported a very satisfied with the procedure rating and a reduction of 1 1/2 inches of he waistline which is now 25 1/2 inches. The back scars were perceptible and were white in color. There were no limitations or discomfort in any physical activity that she wanted to do.
In my experience with rib removal surgery for waistline narrowing patients report a range of 1” to 3” in circumferential waistline reduction with the final result is evident months later.This patient’s result falls right in the median of this reported outcome range. Does her height (5’2 have any influence on the final result? Would it have been greater had she been taller, had not had a prior BBL or had a greater than 27 waistline initially? These issues all influence the final result and their exact contributions are not exactly known. But it speaks to the variable results that can occur in any individual patient.
Case Highlights:
1) Rib removal achieves its effects by a combination of hard and soft tissue reductions along the waistline.
2) By patient accounts rib removal achieves a 1” to 3” inch reduction in circumferential waistline reduction. In this case it as 1 1/2 inches.
3) Rib removal scars heal well but not in a completely inconspicuous fashion.
Dr. Barry Eppley
Indianapolis, Indiana