Rib Removal: What You Need to Know

Pros 

• People with certain medical conditions, such as iliocostalis syndrome or thoracic outlet syndrome, can benefit from rib resection to alleviate their symptoms.
• This procedure can also create a dramatic contrast between the size of the waistline and hips, giving patients an extreme hourglass figure or "wasp waist."

Cons

• Rib removal surgery comes with serious risks, including the possibility of perforated internal organs.
• Because the procedure is so controversial, it can be difficult to find an experienced, board-certified plastic surgeon who is willing to perform it. Many people seek rib removal surgery overseas where safety protocols tend to be less stringent. This can increase your chances of complications.
• There is a lot of pain associated with this surgical procedure, and it comes with a lengthy downtime.
• If you have any regrets about this procedure, the surgery cannot be reversed; ribs cannot regrow or be grafted back on.

Related: 6 Key Things to Do If You’re Traveling Outside the U.S. for Plastic Surgery

Some people seek out rib removal surgery to create a smaller waist. Transgender women in particular sometimes opt for rib removal surgery to create a more traditionally feminine silhouette. In these situations, rib removal is sometime paired with a tummy tuck, Brazilian butt lift, and/or breast augmentation, for full body contouring.

Rib removal can help people with medical conditions like rib asymmetry or iliocostalis syndrome, where friction from the lower ribs irritates the soft tissue of the iliac crest. 

Cancer, injury, and thoracic outlet syndrome (a disorder that develops when blood vessels or nerves are compressed) are other medical reasons people seek out procedure. 

In some cases, part of a rib bone is removed to be used in a bone graft for reconstructive surgery.

Rib removal surgery techniques and methods depend on your surgeon's preferences, your anatomy, and whether the surgery is done for medical or cosmetic reasons. 

The procedure will always be performed under general anesthesia, with an overnight hospital stay and an at-home recovery period of several weeks. 

The bottom ribs (the 11th and 12th ribs), are commonly called the floating ribs because they don’t attach to the sternum (or breastbone) in the way that the first ribs do. When viewing an x-ray of your upper body, you can see that these bottom ribs don't attach to the front of the ribcage at all—only the back. 

That makes it less risky to remove these bottom ribs than it would be to remove ribs higher up on the ribcage, so they can be safely removed by an experienced, board-certified surgeon.

According to NYU Health, a surgeon can make an incision above the clavicle or under the arm, cut and remove the ribs, and then close the incision with sutures or surgical glue.

When it’s done for body modification reasons and there’s a strong desire to avoid scarring, this cosmetic surgery involves making small incisions on both sides of the spine, cutting the rib where it attaches to the back of the ribcage, and carefully working the removed rib out through the incisions. This method comes with a greater risk of perforating the thorax and internal organs (like a lung), which is why so many plastic surgeons don't perform it.

You'll be under general anesthesia for the surgery, so you won't feel any pain during the procedure. However, the ribs are a sensitive area, so yes, there's pain involved in the recovery. You can expect to have swelling, bruising, and soreness for a few weeks after surgery. 

"Rib surgery is very painful and can produce long term tenderness when a rib is broken or cut," says Dallas, Texas plastic surgeon Dr. David Morales. 

Your surgeon will likely prescribe pain medication for the first several days of your recovery. After that, you can take over-the-counter pain meds to help keep you comfortable.

You'll need at least two weeks of downtime after surgery, if not three or four (especially if your work involves bending and lifting). 

You'll be restricted from certain activities during that recovery time while your body heals, and you may need to wear a waist trainer for several weeks after that.

Rib removal surgery can be done safely, but how safe it is depends on your surgeon’s technique and level of experience. There may be a risk of damage to your organs, including a collapsed lung. Like every surgical procedure, it also carries risks of infection, seroma, or hematoma.

Related: 5 Dangerous Procedures to Avoid—and What to Get Instead

When the question of safety has been asked on RealSelf, doctors’ opinions are split. 

Plastic surgeon Dr. Tim Neavin of Beverly Hills, California, says the procedure “is safe if performed by a board-certified plastic surgeon.” 

Dr. Robert Singer, a plastic surgeon in La Jolla, California, says rib removal surgery comes with “significant risks” that prevent him from recommending it as a cosmetic procedure.

Dr. Singer also says he believes most patients who contact him about rib removal surgery have some form of body dysmorphia, a form of obsessive-compulsive disorder.

Related: 5 Common Reasons Plastic Surgeons Will Refuse to Operate On You

Costs can vary widely, depending on your surgeon’s level of experience, their practice location, and whether the plastic surgery is purely cosmetic. 

If it’s being done to correct a documented medical condition, your insurance plan may cover a portion of your cost.

Dr. Neavin charges $25,000 for removal of the bottom ribs.