What Is Rib Remodeling Surgery?

Rib Remodeling Surgery, also known as RIBXCAR or Rib Contouring Surgery, has gained increasing attention worldwide as a body contouring procedure designed to create a narrower waistline.

Unlike traditional rib removal surgery, Rib Remodeling does not remove the ribs entirely.

Instead, the procedure intentionally creates a controlled incomplete fracture in the lower ribs, typically the 10th–12th ribs, allowing the rib angle to be repositioned inward.

The goal is to enhance:

• Waist definition
• Hourglass body contour
• Overall body proportions

The Most Important Part of the Procedure: Controlling the Bone

During RIBXCAR and Rib Remodeling Surgery, a portion of the rib is carefully weakened by shaving part of the bone.

Typically, approximately one-third of the rib thickness is reduced to create a controlled incomplete fracture.

However, because parts of the procedure are performed without direct visualization of the entire rib surface, surgical precision and tactile feedback are extremely important.

If excessive force is applied, the rib may develop a complete fracture instead of the intended incomplete fracture.

Why Is a Complete Fracture a Concern?

A complete fracture may result in:

• Increased pain
• Rib instability
• Displacement of bone fragments
• Longer recovery time

More importantly, surrounding organs may theoretically be at risk.

The lower ribs are located near:

• Lungs
• Diaphragm
• Liver
• Spleen
• Kidneys

Excessive displacement of a fractured rib could potentially contribute to complications such as:

• Pneumothorax
• Hemothorax
• Organ injury

Who Should Perform Rib Remodeling Surgery?

Although Rib Remodeling Surgery is often discussed within aesthetic medicine, it is fundamentally a procedure involving bone.

For this reason, AVAN TOKYO believes that the involvement of an orthopedic surgeon—someone who routinely treats bone injuries and fractures—can provide significant advantages in terms of safety and surgical planning.

AVAN TOKYO’s Safety Protocol

At AVAN TOKYO, Rib Remodeling Surgery is performed using a three-physician team approach.

Orthopedic Surgeon

Responsible for bone assessment and fracture control.

Plastic Surgeon

Responsible for aesthetic design and soft-tissue management.

Board-Certified Anesthesiologist

Responsible for general anesthesia and perioperative safety.

This multidisciplinary approach helps maximize both safety and aesthetic outcomes.

Why We Perform Ultrasound Immediately After Surgery

Postoperative evaluation is an essential part of patient safety.

Immediately after surgery, we perform ultrasound examination to assess:

• Whether an unintended complete fracture has occurred
• Whether pneumothorax is present
• Whether there are signs of thoracic complications

Early detection allows prompt management when necessary.

More Than a Waistline Procedure

Rib Remodeling Surgery is often promoted as a procedure to create a smaller waist.

However, it is a technically demanding operation involving bone anatomy, surgical judgment, and postoperative management.

At AVAN TOKYO, we prioritize patient safety while pursuing balanced and natural body proportions.

Risks and Potential Complications

Pain, swelling, bruising, delayed bone healing, complete fracture, displacement of bone fragments, pneumothorax, hemothorax, infection, asymmetry, and scarring.