Serrano-Reyes, Hector Mauricio

Background: Body contouring is an increasingly common trend in aesthetic plastic surgery. In the pursuit of ideal body proportions, anterior thoracic cage deformities, especially lower rib cartilage prominence have emerged as a frequent source of dissatisfaction. To address this concern, the anterior aesthetic rib cage remodeling with osteosynthesis (ARCO) technique was developed as an innovative method to reshape the anterior rib cage. Methods: A retrospective study was conducted in Colombia on patients who underwent the ARCO procedure. Preoperative and postoperative rib cage perimeter measurements were recorded. Spirometry was performed preoperatively and during long-term follow-up to assess potential changes in respiratory volumes. Intraoperative peak pressure and pulmonary compliance values were monitored to evaluate procedural safety. Postoperative satisfaction was assessed using the BODY-Q questionnaire, and all complications were documented. Results: A total of 34 patients were included, with a mean age of 34 years. A significant reduction in the inferior rib cage perimeter at the level of the eighth rib was observed (Mann-Whitney U =190, P < 0.001), with a mean decrease of 2 cm. Intraoperative peak inspiratory pressure and pulmonary compliance remained stable across all procedural stages. Spirometric analyses revealed no restrictive changes in respiratory volumes. Conclusions: The ARCO technique offers an effective approach for reducing chest circumference and enhancing the aesthetic contour of the anterior rib margin while achieving high patient satisfaction. It involves a controlled greenstick fracture followed by osteosynthesis to create a stable and natural rib curvature, reducing the risk of malunion and eliminating the need for postoperative corsets.

Background: Rib cage remodeling has shown promising aesthetic results as a new technique for body contouring, and yet risks and complications associated with the procedure have not been well established. The aim of the authors’ study was to assess safety, efficacy, and patient satisfaction rate associated with a new surgical technique for waistline definition. Methods: The authors looked into their records for patients who underwent waist narrowing through a new rib remodeling procedure with osteosynthesis of ribs XI and XII from October of 2022 to June of 2023. Follow-up was carried out at 1 and 3 months after surgery. Outcomes were evaluated based on waist and hip measurements, body image, pain, and a patient satisfaction survey. Results: A total of 27 consecutive patients were included in the analysis. The authors’ technique resulted in a significant reduction in waist circumference, as evidenced by a decrease of 12.1 cm and 13.0 cm at the first and third months, respectively ( P < 0.005). A reduction of hip circumference of 6.2 cm and 8.7 cm at the first and third months, respectively, was also reported. A high patient satisfaction rate was reported. Postoperative complications included only 1 case of wound dehiscence and 1 case of mild pain. Pain levels were also reduced, with a mean pain score of 2.4 at week 1 and 0.26 at month 1. Conclusions: Rib osteotomy with osteosynthesis emerges as an innovative, safe, and reliable approach for waist narrowing. The authors’ results suggest that this technique can be applied to a wide variety of patients, and it might entail significant advantages compared with other techniques. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.