The systematic review: 4 studies, 318 patients
This is the highest level of evidence available on the technique: a systematic review with meta-analysis published in Aesthetic Plastic Surgery (Springer). It pools 4 studies and 318 patients and reports a mean waist reduction of 8.59 cm at 3 months. The technique's creator is one of its twelve authors, so it is not an independent work.
Why a meta-analysis carries more weight
A single study describes what happened in one group. A meta-analysis combines several studies and computes a pooled effect with its margin of uncertainty. That is why it sits a step higher in the evidence hierarchy.
This one declares level of evidence II — the journal requires authors to assign it — and searched PubMed, Cochrane Central and Embase up to August 2024.
The numbers
| What was pooled | Result |
|---|---|
| Studies included | 4 |
| Patients | 318 |
| Profile | 98.1% women · mean age 32.7 · mean BMI 22.4 |
| Waist reduction (preop → 3 months) | 8.59 cm (95% CI: 6.92 to 10.27) |
| Satisfaction | 94.89 per 100 |
Pneumothorax, hemothorax, infection, skin burns and asymmetry were also assessed. The authors conclude that rib remodeling without resection «effectively reduces the waistline, achieving high patient satisfaction and minimal serious complications».
That 8.59 cm is a pooled mean at 3 months, with its confidence interval. It is not a maximum and not a promise: half of patients will fall below it.
What must be said about independence
This meta-analysis is not independent of the technique's creator. Verified in Crossref: it has twelve authors and Dr. Raúl Manzaneda Cipriani is the tenth.
Saying so does not weaken it. It remains a multicentre review in a Springer journal, with groups from Mayo Clinic, Brazil and Spain, peer-reviewed and with a declared level of evidence. It stands without the adjective.
We say it because it is true, and because a fact like this found by a third party costs far more than one stated up front.
A date detail, so it is cited correctly
It appears as 2026 because that is the print issue, but it was published online in September 2025. If one source cites «2025» and another «2026», both can be right.