Is There Scientific Evidence on the Practice of Rib Resection or Remodeling for Body Contouring Purposes?-A Systematic Review.

introductionRib resection and remodeling have gained attention as cosmetic procedures to enhance body contours, particularly waist-to-hip ratio. Historically, rib resection has been used for medical reasons; however, plastic surgeons have recently adopted it for aesthetic purposes. However, concerns remain regarding the safety and effectiveness of the procedure, particularly due to the potential for complications, such as pneumothorax, chronic pain, and impaired respiratory function. This systematic review aimed to assess the existing evidence on rib resection or remodeling for body contouring.

methodsA systematic review was conducted following PRISMA guidelines. Databases including PubMed, EMBASE, Cochrane, and others were searched for studies involving rib resection or remodeling for aesthetic purposes. Studies were selected based on predefined inclusion criteria, including adult patients and outcomes related to waist circumference reduction, adverse events, and patient satisfaction. Risk of bias was assessed using the ROBINS-I tool.

resultsThis review included 12 studies that revealed variability in techniques, patient selection, and outcomes. Rib resection was associated with significant risks such as pneumothorax and chronic pain; however, newer rib remodeling techniques, such as green-stick fractures and rib shaving, showed fewer complications. Despite promising results in some cases, the lack of long-term studies and randomized clinical trials limits the ability to draw definitive conclusions regarding the efficacy and safety of these procedures.

conclusionRib remodeling appears to offer a less invasive alternative to full-rib resection, with a reduced risk of complications. However, the current literature is insufficient to provide conclusive evidence regarding the long-term safety and efficacy of these procedures. Further high-quality studies, including randomized trials, are needed to inform surgical practices and patient decision-making regarding rib-based body contouring. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .