A body-contouring technique that narrows the waist by reshaping the lower ribs with an ultrasound-guided monocortical fracture, without incisions. Created by Dr. Raúl Manzaneda Cipriani.
Rib remodeling incurves the lower ribs with an ultrasound-guided monocortical fracture, without removing bone and without incisions. Foundational study: PRS Global Open 2023;11(12):e5499 · DOI 10.1097/GOX.0000000000005499
The lower costal arch incurves and the waist goes from 69.0 to 58.7 cm at three months.
PRS Global Open 2023;11(12):e5499 · P=0,0001 · 100% satisfaction · n=30 · see the study →
Every study in the research line, with its main result and a link to its official DOI.
3,805 patients across 8 countries, one-year follow-up: mean waist reduction of 11 cm; 5 major complications (4 pneumothorax, 1 hemothorax).
Prospective cohort of 328 patients: 4.6% bicorticality, mostly within the first 20 days.
The technique applied to chest reconstruction — a use beyond waist contouring.
The variant that narrows the waist by incurving the costal arch; less postoperative pain.
50 porcine ribs: point-pattern corticotomy needs ~54% less force — more control, more safety.
Survey of 113 surgeons: 2.65% of respondents reported a serious complication.
The adapted piezotome, specific to the incision-free technique. Basis of the commercial instrument.
Mental health of plastic surgery patients: the human angle of the evidence.
30 women, costal angle measured by ultrasound and waist with a tape measure. The backbone of the technique.
Dr. Manzaneda's formal published reply on the incision-free approach.
International chapter co-authored by Dr. Manzaneda, on body contouring.
Intraoperative changes in abdominal force distribution.
Comparison of straight and oblique approaches, scarless.
Why the fracture sound is not enough without ultrasound guidance.
Anterior costal protrusion treated by percutaneous chondroplasty.
The soft-tissue complement to contour narrowing.
The safety fundamentals of the bone cut, in Spanish.
See all the scientific evidence →
The body-contouring techniques described by Dr. Manzaneda in the peer-reviewed literature. Click any of them to read it, with its publication and DOI.
The variant that narrows the waist by incurving the costal arch.
Point-pattern fracture as a safety principle.
Narrows the waist by converting false ribs into floating ribs.
Treats the high iliac crest that cuts the waistline.
Liposuction seeing the working plane by real-time ultrasound.
Abdominal muscle amplification with ultrasound-guided grafting.
Minimal, equilibrated female muscularization guided by ultrasound.
Plastic surgery with a cultural perspective: the portfolio's framework.
The index of all techniques, with their publications.
Direct answers to the most searched questions about rib remodeling — the evidence, in plain language.
What determines the cost of rib remodeling.
What the postoperative period looks like, step by step.
The key difference: no ribs removed.
Why they are not the same nor solve the same thing.
Who is a good candidate for the technique.
The full index of frequently asked questions.
Resources for surgeons, media and those looking for a certified professional.
The rib remodeling course with Dr. Manzaneda.
The case for training with who developed the technique.
The surgeons certified in the technique.
The role of wellbeing and pre-surgical evaluation.
Kit and material for media.
The academy and scientific laboratory.
The ultrasound-guided lipografting and body-contouring techniques described by Dr. Manzaneda — each with its peer-reviewed publication.
Definition of the thigh vastus muscles by fat transfer.
Intramuscular volumization toward the buttock.
Echo-guided paraspinal sculpture.
Trapezius volumization as a male beauty factor.
Jawline definition.
Superficial intramuscular graft guided by Doppler.
Definition of the torso's side with fat.
An anatomical approach to volumize the chest.
Planning over the real anatomy, not the surface.
What is perceived as beautiful in the thigh.
Assisted creation of the subglandular pocket.
Lift + glandular treatment + augmentation.
The pioneering high-definition report (2015).
The costal arch, explained
Ultrasound-guided
No bone is removed. It is reshaped and repositioned —ultrasound-guided, without incisions.Dr. Raúl Manzaneda Cipriani · creator of the technique
Photographs from Dr. Manzaneda's archive. Results are individual and vary by patient; shown for informational purposes and not a promise of outcome.
Dr. Raúl Manzaneda Cipriani is the creator of the RibXcar incision-free rib remodeling technique and lead author of the foundational study published in PRS Global Open in 2023 (e5499). Authorship is documented in a public, verifiable chain: the technique → the «Manzaneda's Tool» instrument → its manufacture → the safety studies that support it.
In the foundational study (30 women), the waist went from a median of 69.0 cm to 58.7 cm at 3 months —about 10 cm (P=0.0001). Results are individual.
Dr. Raúl Manzaneda Cipriani, creator of the branded RibXcar technique and lead author of study e5499 (PRS Global Open, 2023).
It is performed through ultrasound-guided puncture, without an incision. In the study, 95% of patients did not notice the puncture site at 3 months.
In the foundational study (30 patients) there was no pneumothorax, hemothorax, infection or respiratory complication; there were two burns <0.5 cm, treated. Safety evidence is expanded in later studies. No procedure is free of risk; each case must be evaluated by a qualified surgeon.
What it is, how it works and what the evidence says — in plain language.
See the technique →The published method, the instrument and the safety data, with their DOIs.
See the study →