How it works
Unlike techniques that remove bone, rib remodeling reshapes the lower ribs. The procedure is ultrasound-guided to produce a controlled monocortical fracture that reduces the diameter of the costal arch and, with it, the waist circumference, while preserving bone integrity. "Clack" and imaging control are part of the published method (DOI).
What it is NOT
Rib remodeling is not rib removal: it does not take out bone structure, nor does it require an open approach. That is why its risk profile differs from resective techniques (see safety).
The instrument
The technique is performed with a piezotome adapted by the doctor himself —"Manzaneda's Tool"— published in PRS Global Open (2024) and manufactured by his team and distributed by Marina Medical.
Evidence
The technique has more than a dozen peer-reviewed publications, including a prospective cohort of 328 patients and a safety evaluation across 113 surgeons. See all the evidence →