Exotic Surgery in the RGV 



RGVision Magazine recently sat down with Dr. Filiberto Rodriguez (MD, FACS, FAACS, RVT, RPVI) of RGV Cosmetic Surgery & Vein Center to discuss how he performs rib cage modification surgery for patients who would like a smaller waistline. Although rib modifications have been around for quite some time, it is not a common request from patients, especially due to the fact that qualified surgeons for this procedure are few and far between. 

Can you explain why a patient would seek rib modification?

It’s really on the edge of what’s considered cosmetic surgery to really alter a figure. It’s very common among transgender men, for example, who want to have a narrower waist, but there’s also a lot of women who just have a very boxy figure.

It is much more of an exotic surgical procedure. This is not something that’s done by everyone; it’s done by select cosmetic and plastic surgeons with training. My background is in thoracic surgery, so I’m used to removing ribs for other reasons, lung cancers — and that’s a totally different operation — but using that expertise allows me then to do this cosmetic surgical procedure of rib modification very safely.

How is rib modification performed?

When we talk about rib modification, it’s removing the bottom floating ribs that are amenable. There are two basic approaches for rib cage modification: either we go through a modified tummy tuck (abdominoplasty) approach from the front, go in, and take the ribs, or we make an incision on the patient’s back, two incisions right where we’re going to have to do the work to remove those ribs. Some women don’t like those external scars [on the back], so I think most opt for the modified abdominoplasty approach.

The floating ribs are very quite easily removed. They’re called floating ribs for a reason. Yes, they do help protect the kidneys, but we don’t resect all of the floating rib. There’s still protection for the organs. We’re just resecting the front portion of it that allows us to create that smaller waist.

How does a surgeon ensure patient safety during this procedure? 

The basic answer to that honestly is “Are you a skilled, trained surgeon? Period.” There is inherent risk in all surgery that we do. When we’re doing a rib cage modification, the care we have to take as surgeons is just to stay outside of the abdominal cavity. There’s a thin layer between the ribs and the actual organs that you can just stay out of. We’re not going intra-abdominal; we’re just going deeper into the muscle than we do in a normal tummy tuck.

What is the outcome of this procedure in terms of the patients’ figure?

The outcomes are pretty dramatic. You see a difference even without it when we do a good lipo case and a tummy tuck case because by tightening the muscles of the tummy tuck, the patient is getting an enhanced waist. So, if you do the rib cage modification and excise those lower floating ribs, the amount we can tighten is dramatic, and that’s when you can see the big improvement.

Are the results natural looking?

The results for a rib cage modification are extremely natural, and they just help a woman who feels that she has a little bit of a boxy figure get more of an hourglass shape. Like I said earlier, this is also very common in the transgender community to give themselves more of a waist. 

What is the recovery time following rib modification?

If we do a rib modification through the tummy tuck approach, it actually doesn’t add anything to the recovery time of the abdominoplasty itself. My tummy tuck patients are usually back to work after 10 to 14 days, walking and functioning, not hunched over or miserable like people talk about. That’s not our experience. The only people who need to take a full six weeks off are people whose jobs require heavy lifting because after these procedures you can’t lift anything more than 10 pounds, and you can’t do sudden jerky movements. 

The rib cage modification, if it’s done by itself, is similar to a tummy tuck in terms of those 10 to 14 days of recovering. But, like I said, that approach is not as common because most people just don’t want those two scars behind their back, and they’d rather just do it through the modified tummy tuck approach.

What else do patients need to know prior to scheduling this procedure?

The number one thing prior to scheduling any cosmetic procedure is asking yourself if it’s something you’re personally ready for. You’re making an investment, not only a financial investment but a physical investment in your own body. What I like to say is that your body is not an experiment. You really want to make sure you’re picking the right and the safest surgeon for your procedure. That’s the number one consideration I would tell people considering any kind of cosmetic surgery, but especially something exotic like a rib cage modification. You really want to go with someone who understands the anatomy and can safely handle any issues. 

There’s that level of comfort when you’re dealing with a truly experienced and skilled surgeon versus someone who’s kind of making it up as they go along; that’s what you want to avoid.  

RGV Cosmetic Surgery & Vein Center is located in Edinburg and has helped patients from all over Texas and the nation achieve their ideal body goals. To learn more about the cosmetic procedures available, call (956) 477-1670 or go to www.RGVCosmetic.com

RGV Cosmetic Surgery & Vein Center

Address:  3131 W Freddy Gonzalez Dr, Edinburg, TX 78539