Key result
RibXcar rib remodeling with breast augmentation linked to a ~13% reduction in waist circumference.
Why the study?
The waist-to-hip ratio plays a decisive role in the perception of femininity in transfeminine patients, and rib remodeling has recently been described as an innovative adjunct to thoracic feminization.
Does rib remodeling combined with breast augmentation improve waist-to-hip ratio and patient satisfaction in transfeminine patients?
Case Report (n=1)
Does rib remodeling combined with breast augmentation improve waist-to-hip ratio and patient satisfaction in transfeminine patients?
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.
May support rib remodeling with augmentation for waist contouring in transfeminine patients; hypothesis-generating and requires prospective validation.
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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González et al. (2026) 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.
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