Abdominoplasty alone is insufficient for patients with asymmetric rib cages. In order to achieve a symmetric result in these cases procedures such as partial rib removal or shaving are performed as part of the abdominoplasty. The advantage of doing it this way is the avoidance of a large visible scar that would be required to directly access the asymmetric ribs.
This 34 year old, 5’4″, 112 pound patient had prominent lower left ribs that she wished addressed. She had never been obese or pregnant and had no hanging abdominal skin but still benefited from an abdominoplasty with removal/shaving of the lower and front halves of the lower ribs on the left.
Video: Abdominoplasty with Rib Shave
Read Dr. Stone’s blog about abdominoplasty and belt lipectomy surgeryAbdominoplasty, thigh buttock lift and belt lipectomy
Cellulite
Abdominal Muscle Tightening and Diastasis RepairThe Difference between Panniculectomy and Abdominoplasty – Tummy Tuck
Rib removal surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.
Alternatives
Aside from removing or reshaping the rib asymmetry there are no reliable and safe surgical alternatives to adjust rib visibility. These are not cases where gaining weight to cover your ribs will suffice.
Risks
As with any type of surgery there is the risk of infection or bleeding. Additionally there is the risk of seroma or blood fluid collections under the skin, bruising and skin loss especially at the lower edge of the abdominal skin below the belly button and the middle of the lower back. Smokers and those who have undergone massive weight loss prior to surgery are at particular risk for skin loss or clots in the major leg veins.
Nibbling at or shaving the edge of a rib is less risky than rib removal and usually does not require hospital surgery or stay.
This risks are minimized by careful surgery, use of drains, medical optimization of at risk patients before surgery, early ambulation after surgery and adherence to postoperative instructions.
Constipation is a frequent problem following muscle tightening surgery and opioid pain medications after surgery. Dr. Stone has his patients routinely take stool softeners beginning a few days before surgery to minimize this problem.
The appearance of the skin incision scars after surgery is highly variable from patient to patient. With good scar control regimens after surgery the visible scarring can be minimal even in Afro-Americans.
Benefits
The benefits are not being self conscious shopping for clothes, in a bathing suit at the beach, when wearing midrif exposing shirts or when being intimate and achieving a more hourglass shape for women. Being pleased with your new appearance can be a major incentive to changing your lifestyle, diet and exercise regularity in order to maintain your new look.
Recovery
Patients require an overnight stay in a nursing facility and most go home the following day. A urinary catheter is left in place overnight and the drains are removed within 3 to 7 days of surgery in most cases.
The main factor affecting complication free recovery is the amount of muscle tightening that is performed at surgery. If the muscles were very lax before surgery you may not be able to walk upright for 2 or 3 weeks after surgery. There are exercise and activity restrictions for 3 to 4 weeks after surgery after which patients gradually return to their pre-surgery exercise routines.
Dr. Aaron Stone
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9700 Venice BlvdCulver City, Los Angeles,CA 90232