The largest published study on RibXcar rib remodeling is a multicenter cohort of 3,805 patients from 8 countries, with one-year follow-up for all of them. Mean waist reduction was 11 cm and there were 5 major complications (4 pneumothorax, 1 hemothorax). Published in PRS Global Open in 2026.
What was studied
A cohort of 3,805 female patients aged 18 to 45 (mean age 31.7), who underwent RibXcar across 8 countries between October 2022 and December 2023, with or without associated liposuction. All received one year of follow-up after surgery.
During follow-up, complications, rib angular variation and waist reduction were assessed. Satisfaction was measured with the BODY-Q questionnaire, a validated instrument for body contouring surgery.
The results
| What was measured | Result |
|---|---|
| Patients | 3,805, from 8 countries |
| Follow-up | 1 year, all patients |
| Mean waist reduction | 11 cm |
| Mean angular variation (ribs 10, 11 and 12) | 10 degrees |
| Major complications | 4 pneumothorax · 1 hemothorax |
| Minor complications | 2 cases of chronic pain associated with bicortical fracture |
The mean angular variation of 10 degrees held regardless of the associated surgery, that is, both in patients who also had liposuction and in those who did not.
Why this study matters
The foundational study (e5499) described the procedure in 30 patients. This cohort tests it at a scale 127 times larger, across eight different countries, with different surgeons.
That is the difference between "the technique works in the hands of the person who created it" and "the technique works when other teams apply it, in other countries, and patients are followed for a year". The second question is the one that decides whether a procedure gets adopted.
About the complications
The 5 major complications across 3,805 patients should be read with two caveats.
First: these are the complications this study documented, in this cohort and with these surgeons. They are not a universal rate nor a guarantee. A cohort study describes what happened, not what will happen.
Second: the authors note that all were managed per standard clinical practice and resolved without lasting functional consequences in the documented cases. That last qualifier is theirs and we keep it: no surgical procedure is free of risk, and pneumothorax is a known, described risk of any surgery on the chest wall.
Anyone evaluating the technique should also read the safety page and the bicorticality study in 328 patients, which looks specifically at the most frequent complication.
Who signs it
Nine authors, led by Dr. Raúl Manzaneda Cipriani, the creator of the technique. They include surgeons from several of the countries in the cohort. This is not a study independent of the technique's creator: he is the first author, and that should be stated when reading the results.