Your Questions

Q: Dr. Eppley, Is there a way I can find out more about the rib cage narrowing you have posted on your website? I am interested in this procedure and would like to know more about how it is done, costs involved, and recovery time. Thank you.

A: Ribcage narrowing, also called waistline narrowing surgery, is done by removing the 9th and 10th cartilaginous ribs (and occasionally the 8th) to make the waistline vertically longer and narrower from the sides by removing the bulges of the ribs. It is a procedure that may be effective for some patients based on their anatomy and if they are already fairly thin. It is done through a 4 to 5cm incision directly under the rib cage on each side. One has to carefully balance whether the thin scars are a good trade-off for the result. Recovery is solely based on the level of discomfort and is, of course, quite similar to traditional rib graft harvesting for rhinoplasty or mandibular reconstruction with the exception that it is done on both sides. Immediate pain management is aided by the use of rib nerve blocks and infiltration of long-acting local anesthetics into the rib and abdominal musculature. It is done under general anesthesia as an outpatient. The total cost of the procedure is around $6500 – $7500.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, do you perform rib removal/resection surgery? Perhaps shaving down of ribs? I have one side of my lower chest that juts out too far and it is definitely from the ribs. I have attached some pictures so you can see what I mean. I hope to hear from you soon.

A: Thank you for your inquiry. Yes I routinuely perform rib grafting harvesting for rhinoplasty as well as occasionally done rib resection/shaving for chest contouring. It appears from the pictures is that your left subcostal area( ribs 6 through 9) protrude compared to the more normally-shaped right side. For left subcostal chest contouring, you need the cartilaginous portions of ribs 8 and 9 removed and ribs 6 and 7 shaved (beveled down) to get rid of the portion that sticks outs. This is done through a low subcostal incision of about 4 cms.

Dr. Barry Eppley

Indianapolis,Indiana