British surgeons question rib remodelling after 3.7% complications

Sandip Hindocha, a London consultant plastic surgeon, and BAAPS questioned rib remodelling in a Guardian Health feature Oct. 28, after a paper reported a 3.7% complication rate in 2,351 patients from 2018 to 2024.

The procedure matters because it permanently changes the rib cage for cosmetic contouring: patients may have three lower ribs on each side fractured, then wear a corset for three months while the bones heal.

Rib remodelling is described as an alternative to rib removal, an older cosmetic approach that reduces the bony protection around organs including the liver and spleen. The Guardian reported that the newer method is performed under general anaesthesia and can take about an hour as day surgery.

Hindocha questioned whether patients are getting enough time to weigh the permanence of the operation. “If a patient came to my clinic and said this is what I want to do, I’d be asking the question: ‘Why do you want to do that? And why do you want to make such a permanent change to your body?’”

he said.

The British Association of Aesthetic Plastic Surgeons does not endorse the procedure, according to the article. Former BAAPS president Nora Nugent said rib remodelling is relatively new, “with limited data available on long-term results and it requires advanced body contouring skills as well as the ability to treat any potential complications.”

The Guardian described Daniela Cesin, 31, who travelled from Miami to Venezuela in August for liposuction and a fat transfer, then was offered RibXcar after her surgeon said she did not have enough fat for the original plan. Cesin said she wanted “that guitar hourglass shape.”

According to the article, Cesin’s surgeon used ultrasound, made six small incisions in her back and created incomplete fractures in three lower ribs on each side. Six weeks later, she told the Guardian she was pleased with an eight-centimetre reduction in her waist, though recovery included poor sleep, incision soreness and acid reflux while wearing a corset for 23 hours a day.

The medical risks cited in the article include allergic reactions to anaesthesia, blood clots, wound infections and seromas, which are pockets of fluid under the skin. More specific risks include pneumothorax, a collapsed lung, and haemothorax, blood collecting between the chest wall and lungs; the Guardian described both as potentially fatal.

One patient identified as Sophia told the Guardian she had a pneumothorax after surgery in Beverly Hills in November 2025, with a CT scan showing 25% of one lung had collapsed. She said she had signed consent forms but the complication was “completely shocking to me.”

The article said rib remodelling is not typically offered to cisgender women over 40 because of osteoporosis risk, which can make bones more likely to fully break rather than fracture. It also said weight gain and pregnancy can alter body shape after the procedure.

The study cited in the Guardian article can describe reported complications among patients included in that paper, but it does not settle long-term safety, patient selection or how outcomes compare across surgeons and countries. UK plastic surgeons are advised to give patients at least a two-week cooling-off period before cosmetic procedures, according to the article.

Source: news feature, The Guardian Health, Oct. 28, 2026.

Atlas360 reports health research and does not provide medical advice.