Rib remodeling using the RibXcar technique combined with breast augmentation reduced waist circumference from 77 cm to 67 cm and improved waist-to-hip ratio from 0.9 to 0.8 at 4 months.
Case Report (n=1)
Does rib remodeling combined with breast augmentation improve waist-to-hip ratio and patient satisfaction in transfeminine patients?
30-year-old transfeminine patient (n=1)
Breast augmentation with 300 cc silicone implants combined with rib remodeling using the RibXcar technique (controlled fractures of the 10th-12th ribs via small posterior axillary incisions)
Waist-to-hip ratio (WHR) and waist circumference at 4 monthssurrogate
Rib remodeling using the RibXcar technique combined with breast augmentation effectively reduced waist circumference and improved waist-to-hip ratio in a transfeminine patient without complications.
Background: Gender-affirming surgery is a cornerstone of comprehensive care for transgender individuals. In transfeminine patients, the waist-to-hip ratio (WHR) plays a decisive role in the perception of femininity. Rib remodeling has recently been described as an innovative adjunct to thoracic feminization. Case presentation: We present the case of a 30-year-old transfeminine patient who underwent breast augmentation with 300 cc silicone implants combined with rib remodeling using the RibXcar technique. Preoperatively, the WHR was 0.9 (waist: 77 cm; hips: 84 cm). Controlled fractures of the 10th-12th ribs were performed via small posterior axillary incisions. Results: At 4 months, CT imaging confirmed rib remodeling with reduced intercostal distances. Waist circumference decreased to 67 cm, yielding a WHR of 0.8. The patient reported high satisfaction, improved body congruence, and no respiratory or functional complications. Conclusion: Rib remodeling appears to be a safe and effective adjunct for thoracic feminization in carefully selected transfeminine patients.
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Tomás González
Ruth Kohnenkampf
Carlos Domínguez
JPRAS Open
Universidad del Desarrollo
Fundación Chile
Clínica MEDS (Chile)
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González et al. (Tue,) conducted a case report in Transfeminine patients seeking gender-affirming surgery (n=1). Rib remodeling (RibXcar technique) combined with breast augmentation was evaluated on Waist circumference and waist-to-hip ratio (WHR). Rib remodeling using the RibXcar technique combined with breast augmentation reduced waist circumference from 77 cm to 67 cm and improved waist-to-hip ratio from 0.9 to 0.8 at 4 months.
synapsesocial.com/papers/6a12577cbb918b6e5b671cb2 — DOI: https://doi.org/10.1016/j.jpra.2026.02.018
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