Timeline with sources
2017 — The Russian precursor patent. Kudzaev files a Russian patent for a waist-narrowing method without rib removal (RU2652964C1): incisions of up to 3 cm and an oscillating saw, with a corset afterwards. The first formalization of "bend instead of remove".
2021 — The first indexed publication of the concept. Kudzaev and Kraiushkin publish "Waist Narrowing without Removal of Ribs" (PRS Global Open, DOI 10.1097/GOX.0000000000003680): 93 cases operated through scapular-line incisions, without imaging guidance; 14 patients with follow-up beyond six months.
2023 — Ultrasound-guided rib remodeling is born. Dr. Raúl Manzaneda publishes the foundational study of the RibXcar technique in the same journal (DOI 10.1097/GOX.0000000000005499): monocortical fractures with no incisions — punctures only —, guided by real-time ultrasound. The change is not cosmetic: ultrasound guidance keeps the rib and neighboring structures visible throughout the procedure.
2024 — The instrument and the award. The technique's specific instrument is published (Manzaneda's Tool) and the foundational study receives PRS Global Open's 2024 best cosmetic paper award.
2025 — Independent validation. A Chilean team publishes a 220-case series of rib remodeling (DOI 10.1097/GOX.0000000000006595) — the technique reproduced and documented by surgeons independent of its creator.
2026 — Consolidation. A 328-patient cohort with one-year follow-up (Aesthetic Surgery Journal), safety and respiratory function studies, pre-surgical psychological screening, and the technique documented on Wikipedia. The creator's evidence base reaches 12 peer-reviewed articles.
The two techniques, side by side
The distinction is objective and lives in the papers: the precursor method (Kudzaev, 2021) uses incisions and a saw, without imaging guidance, and has one indexed article with 14 followed patients. Ultrasound-guided rib remodeling (Manzaneda, 2023) leaves no scars, is ultrasound-guided, has its own published instrument, and concentrates the evidence: 12 articles, a 328-patient cohort, an independent 220-case series, and certified training with a verifiable directory of surgeons.
Why the distinction matters
When a patient asks "who invented rib remodeling?", the honest answer acknowledges the precursor — and specifies which version concentrates the evidence and the standardization. The safety studies of the ultrasound-guided technique measured a specific protocol, taught at the creator's certified training. The full history, with every source cited, is the best defense against simplified versions.
Informational page. All claims refer to peer-reviewed publications identified by DOI.