A Multicenter Cohort Study of 3805 RibXcar Cases: Safety and Efficacy in Incisionless Rib Remodeling

Background: Minimally invasive ultrasound-guided rib remodeling using percutaneous punctures (RibXcar) is a technique designed to modify thoracic contour and reduce waist circumference. This study aimed to describe waist circumference changes 1 year after surgery, as well as to report the occurrence of complications and patient-reported satisfaction. Methods: This was a multicenter cohort study of 3805 patients from 8 countries who underwent RibXcar with or without liposuction (with or without retraction technology), between October 2022 and December 2023. All patients received follow-up care for 1 year after surgery. During follow-up, complications, angular variation, and waist reduction were assessed. Moreover, the BODY-Q questionnaire was used to assess patient satisfaction. Results: A total of 3805 female patients aged 18-45 years (mean age 31.7 y) who underwent RibXcar received follow-up care. The mean angular reduction of ribs 10, 11, and 12 was 10 degrees, regardless of the associated surgery, whereas the mean waist reduction was 11 cm. The major complications included 4 cases of pneumothorax and 1 case of hemothorax, whereas the minor complications included 2 cases of chronic pain associated with bicortical fractures. Conclusions: In this prospective cohort, RibXcar was associated with a measurable reduction in waist circumference. Reported complications included pneumothorax, hemothorax, and chronic pain; all were managed according to standard clinical practice and resolved without lasting functional consequences in the documented cases.