RibXcar: Safety Fundamentals and Surgical Protocol for Controlled Costal Osteotomy in Body Contouring Surgery: A Prospective Study of 100 Patients

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ID: 332263
2026
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Abstract
Abstract Background Aesthetic body contouring surgery has incorporated costal modification techniques to improve waist definition. The lack of standardized protocols and prospective safety data has generated controversy. The RibXcar technique proposes a controlled monocortical costal osteotomy as an alternative to rib resection; however, no prospective studies have comprehensively evaluated its safety profile. Objectives To describe a standardized surgical protocol for the RibXcar technique and prospectively evaluate its safety, efficacy, impact on pulmonary function, postoperative pain, and patient satisfaction. Methods A prospective study of 100 consecutive patients who underwent RibXcar alone (n=80) or combined with body liposuction (n=20). A 10-step protocol was described, and outcomes were evaluated: complications, pulmonary function (spirometry), waist diameter, costal angulation (ultrasound), pain (VAS), and satisfaction (Body-Q) preoperatively and at 6 months. Results The overall minor complication rate was 8%, with no cases of pneumothorax or hemothorax. Pulmonary function showed no significant changes at 6 months in either group. Waist diameter reduction was 5.0 cm (IQR: 3.75–7.0) in the RibXcar group and 10.50 ± 1.73 cm in the combined group (P < .001). Costal angulation decreased significantly in all evaluated ribs (P < .0001). Body-Q scores improved significantly (P < .00001), and pain resolved by 6 months. Conclusions The results of this series suggest that RibXcar, when performed under a standardized protocol, may constitute a safe and effective alternative for aesthetic rib remodeling in selected patients. The preservation of pulmonary function and the low complication rate observed would support its implementation in advanced body contouring surgery.
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Authors Emmanuel Armando Flores González, Raúl Manzaneda Cipriani, Héctor César Durán-Vega, Gerardo A Adrianzen, José David Salazar, Hassan Ben Moussa, Stefan Danilla
Journal Aesthetic surgery journal
Year 2026
DOI
10.1093/asj/sjag224
URL
https://doi.org/10.1093/asj/sjag224
Keywords Keywords not found

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