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Tummy Tuck Rib Removal

Tummy Tuck Rib Removal

Removing the ribs allows the stomach muscles to be pulled even tighter during the tummy tuck. The results are extremely natural, and they help a patient who feels that they have a boxy figure obtain an hourglass shape.

While modern cosmetic surgery allows patients to be offered less invasive and bloody procedures than before, there are cases where these are not sufficient to give the results that meet patients’ expectations, especially in the case of the upper region of the abdomen.

Tummy Tuck Rib Removal

Tummy Tuck Rib Removal

The most common surgical method of body contouring, including the waist, nowadays, is liposuction.3 However, subcutaneous fat removal helps little in converting the “boxy” shape of the trunk into an “hourglass” in slim individuals. Some patients refer to plastic surgery for resection of XI and XII pairs of ribs, trying to get the desired thin waist.2 However, rib resection seems too aggressive in the context of body contouring. Lower pairs of ribs encompass internal organs, soften shocks, and protect kidneys, adrenal glands, the spleen, and the liver from damage. The removal of ribs may be complicated by hemothorax and pneumothorax. Moreover, a lower lateral rib cage defect may cause loss of respiratory function up to 42% of what is normal.

Rib removal carries the risk of bleeding, infection, and injury to underlying tissues. Thus, it is paramount that it is performed by a skill team. Therefore Dr. Neavin has recruited a reknown, minimally invasive thoracic surgeon to join in the surgery. Dr. Maremaneanu has performed thousands of thoracic surgeries on ribs and has developed innovative approaches to reduce incisions and scars while making the surgery as safe as possible.

Rib removal is a complex surgery. The ribs are close to underlying organs. If not performed properly, there exists a risk of injury to organs. While most plastic surgeons can perform rib removal, they do not have the experience or level of training as thoracic surgeons in this region of the body. Likewise, while a thoracic surgeon can perform a breast augmentation, you probably wouldn’t want your lung surgeon doing it. That’s why Dr. Neavin is one of the top rib removal surgeons in the area.

Rib removal, also known as rib resection, or floating rib removal, has gained popularity in the last several years. Wasp waists and hourglass shapes have again become the aesthetic ideal. While in Victorian fashion this was achieved with laced corsets, today this can be achieved with surgery by removing the “floating” lower ribs, numbers 11 and 12.

Because rib repositioning is a minimally invasive procedure, you can expect less discomfort than after traditional rib removal and a shorter recovery period. Patients often return to their regular routine within two weeks. However, if you add a tummy tuck, your downtime will likely be longer.

Wearing the corset for at least two months after surgery is crucial to the success of this procedure, and you should avoid vigorous physical activity like exercise for six to 10 weeks.

Rib Removal For Smaller Waist

The removal of ribs to create a slimmer figure with a more defined waist is the latest extreme procedure being demanded by women seeking the perfect hourglass figure. Following rumours in the 1970s that Cher had two ribs removed to create a smaller waist, the procedure gained popularity in the USA but surgeons are now reluctant to perform such procedures due to the risks and complications.

The surgery removes the 12th, 11th and, on rare occasions, the 10th rib to create a slimmer waist. The procedure is performed under general anaesthetic with an incision made in the back. Recovery time can be up to six months and patients are left with a long scar.

Although the 12th rib is known as a “floating” rib as it does not extend to the back, the 11th and 10th ribs protect internal organs from the front and back so the removal of these risks damage to the kidneys, gall bladder and even the stomach.

The procedure is now rarely performed by certified plastic surgeons other than in cases such as bone cancer and developmental growth problems where a section of rib is removed to obtain bone for a bone graft. Many have argued that the waist to hip ratio is determined by the  distribution of fat rather than the size of the rib  cage and that exercises such as walking and running are a much safer alternative to rib removal to reduce the waist size.

Emily Palmer, clinical negligence associate at Penningtons Manches, commented: “Not only is it sad to see the lengths to which women will go to achieve what they consider to be the perfect figure but there has also been a sharp increase in the number of these procedures performed in countries where safety requirements are less stringent.

“The removal of ribs is a permanent procedure.  Ribs do not grow back and cannot be replaced. Even under the care of a certified and experienced surgeon, it is a dangerous procedure and the risks of complications are high. Going abroad for the surgery will further increase the risk and complication rate. The healthy, non-surgical alternatives of exercise and diet to achieve a slimmer waist should be actively promoted to anyone considering such an extreme procedure.

Rib Removal Surgery Risks

In cases of severe thoracic outlet syndrome (neurological, venous or arterial) it may be necessary to decompress the thoracic outlet with an operation. This is achieved by dividing some of the muscles inserting into the first rib and then removing a segment of the first rib.

The first rib is a small rib which does not play a significant role in breathing and can be removed without compromising the function of the rib cage.

The procedure is performed under general anaesthesia. The operation may be performed through an incision in the armpit, or more commonly around the collar bone. Once the operative site has been sterilised and the drapes placed, the incision is made. This is deepened through the fat and soft tissues. The muscles (including Scalenus Anterior) attached to the rib are identified. There are several important nerves around these muscles which are protected.

The Scalenus Anterior muscle is divided, exposing the major artery and nerve plexus of the upper limb. By dividing the muscle, this already significantly decompresses the thoracic outlet.

The artery, vein and nerves are protected and the rib is carefully freed from the adherent soft tissues. The first rib is then carefully divided at the front. The rib is then divided further back and a segment removed, often in pieces. This exposes the tough fascia (Sibson’s Fascia) which covers the top of the lung, and decompresses the thoracic outlet. The Subclavius muscle is also divided to ensure complete decompression.

The area is then washed and checked for haemostasis. A small drain is usually placed. The wound is then closed in layers and an invisible dissolving suture placed to close the skin.

Rib removal is a somewhat controversial major surgery that removes one or more ribs, either to address a medical condition or as a cosmetic procedure that creates an hourglass figure, like a Victorian-era corset once did.

It’s sometimes also called rib resection, a technique that entails removing part of a rib. 

Rumors of celebrities like Cher and Marilyn Manson undergoing this surgery have made it a topic of discussion for many who are interested in body modification. However, while some board-certified plastic surgeons will perform this procedure, there’s disagreement within the medical community regarding its safety.

Liposuction (sometimes paired with a tummy tuck) tends to be a preferred option, since it comes with fewer risks.

What are the pros and cons of rib removal?

Pros 

  • People with certain medical conditions, such as iliocostalis syndrome or thoracic outlet syndrome, can benefit from rib resection to alleviate their symptoms.
  • This procedure can also create a dramatic contrast between the size of the waistline and hips, giving patients an extreme hourglass figure or “wasp waist.”

Cons

  • Rib removal surgery comes with serious risks, including the possibility of perforated internal organs.
  • Because the procedure is so controversial, it can be difficult to find an experienced, board-certified plastic surgeon who is willing to perform it. Many people seek rib removal surgery overseas where safety protocols tend to be less stringent. This can increase your chances of complications.
  • There is a lot of pain associated with this surgical procedure, and it comes with a lengthy downtime.
  • If you have any regrets about this procedure, the surgery cannot be reversed; ribs cannot regrow or be grafted back on.

Why would someone have a rib removed?

Some people seek out rib removal surgery to create a smaller waist. Transgender women in particular sometimes opt for rib removal surgery to create a more traditionally feminine silhouette. In these situations, rib removal is sometime paired with a tummy tuck, Brazilian butt lift, and/or breast augmentation, for full body contouring.

Rib removal can help people with medical conditions like rib asymmetry or iliocostalis syndrome, where friction from the lower ribs irritates the soft tissue of the iliac crest. 

Cancer, injury, and thoracic outlet syndrome (a disorder that develops when blood vessels or nerves are compressed) are other medical reasons people seek out procedure. 

In some cases, part of a rib bone is removed to be used in a bone graft for reconstructive surgery.

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