Not necessarily. There are two different surgeries that get confused constantly: one removes the floating ribs and the other reshapes them by changing their angle, without taking out bone. They have different incisions, recoveries and risks. This page explains how to tell them apart.
The two surgeries, side by side
| Rib resection (removal) | Rib remodeling | |
|---|---|---|
| What it does to the bone | Removes it, fully or partially | Leaves it; changes its angle with a controlled fracture |
| Access | Open incision | Puncture, no incision |
| Guidance | Direct vision of the open field | Real-time ultrasound |
| Scar | Yes, from the incision | The puncture point |
| Reversible? | No: the bone is gone | The bone stays; it consolidates in the new position |
Neither is "the good one" in the abstract. They are different options, and which one applies — or whether any does — is decided by a surgeon who examines the patient.
What remodeling actually does
It acts on ribs 10, 11 and 12 — the false and floating ribs, which do not attach directly to the sternum. Through a monocortical fracture, which breaks only the outer layer of bone, the angle of those ribs is changed, and with it the waist contour.
In the largest published cohort — 3,805 patients from 8 countries treated with RibXcar, the incisionless, ultrasound-guided modality developed by Dr. Raúl Manzaneda Cipriani — mean angular variation was 10 degrees and mean waist reduction 11 cm. Results are individual and vary from patient to patient.
"And do the ribs heal back?"
Yes: it is a controlled fracture and it consolidates. In the foundational study, the angles were measured by ultrasound before surgery, immediately after, at one month and at three months, and the variation held over time.
The complication associated with that consolidation is bicorticality — the fracture going through both bone layers instead of one. A study dedicated to measuring it in 328 patients found it in 4.6%, mostly within the first 20 days.
How to know which one you are being offered
Three questions that leave no ambiguity:
- Are you removing bone or not?
- Is it an incision or a puncture?
- Is ultrasound used during the procedure?
With those three answers you already know which of the two surgeries is on the table, regardless of what it is called commercially.
This page explains a technical difference between procedures. It is not a recommendation and cannot tell you whether you are a candidate for either. That is determined by a board-certified plastic surgeon in consultation.
What are the risks? · How the technique works · The published evidence