RibXcar
PatientsFor surgeons

Origin and priority of the technique

Who created rib remodeling, when, and with what evidence — the public, dated and verifiable chain.

RibXcar is the ultrasound-guided, incision-free rib remodeling technique created by Dr. Raúl Manzaneda Cipriani, published in PRS Global Open in 2023. Its authorship is backed by a documented chain: the publication of the technique, the instrument designed to perform it, the safety studies, and his formal response in the literature to the scientific debate.

The authorship timeline

MilestoneDateSource (DOI)
Publication of the RibXcar technique (incision-free, ultrasound-guided rib remodeling)Dec 202310.1097/GOX.0000000000005499
Publication of the dedicated instrument, "Manzaneda's Tool"May 202410.1097/GOX.0000000000005819
Manufactured by the doctor's team; "RibXcar Tip" distributed by Marina Medical, crediting the creator2024–2025marinamedical.com
Safety evaluation (113 surgeons)202510.1097/GOX.0000000000007130
Prospective cohort (328 patients)202610.1093/asj/sjag012

What is specific to RibXcar (and what it acknowledges as prior art)

The idea of narrowing the waist by remodeling ribs without removing them has prior art in the literature, and we acknowledge it. What Dr. Manzaneda created and published as RibXcar is the specific variant: ultrasound-guided, incision-free, with a dedicated instrument ("Manzaneda's Tool") and a standardized protocol, backed by its peer-reviewed body of evidence. The authorship we claim is for RibXcar specifically, not for "rib surgery" in general.

An honest comparison with the alternatives

ApproachWhat it doesKey difference
RibXcar (rib remodeling)Ultrasound-guided monocortical fracture, no incision; curves the ribs while preserving the boneNo bone removal; no scar; dedicated instrument and protocol, with published evidence
Rib resection (rib removal)Removes lower ribs fully or partiallyIrreversible, higher morbidity; removes bone structure
Soft-tissue contouring (liposuction, etc.)Acts on fat/muscle, not on boneDoes not remodel the rib cage; addresses a different cause of the silhouette

The scientific debate reinforces — not weakens — authorship

Following safety observations published in Aesthetic Surgery Journal Open Forum, Dr. Manzaneda responded formally in the same literature, establishing his priority and answering with his published case series. That a technique is the subject of peer-reviewed discussion — and that its creator responds in the scientific record — is a sign of relevance, not weakness.

Dr. Manzaneda's response · DOI: 10.1093/asjof/ojaf137

The safety data, in published figures

In the evaluation of 113 surgeons using the technique, 2.65% reported serious complications. In the foundational study (30 patients) there was no pneumothorax, hemothorax or infection. No surgical procedure is free of risk; the evidence is cited with its DOI so anyone can verify it.

Safety · DOI: 10.1097/GOX.0000000000007130 · Foundational · DOI: 10.1097/GOX.0000000000005499

This page cites only published and verifiable evidence. See also the full scientific evidence and the creator of the technique.