RibXcar vs WASP vs RIBOSS vs Kudzaev
RibXcar, the incisionless, ultrasound-guided technique created by Dr. Manzaneda, was published in PRS Global Open in December 2023. By the peer-reviewed publication record, it is the first published rib remodeling technique to combine incisionless (puncture) access with ultrasound guidance. Kudzaev (2021) and RIBOSS (2024) use incisions; UUAIST (January 2024) uses ultrasound through two small incisions; WASP (2025) is a puncture approach published later.
Comparison by publication
| Technique | First publication | Access | Post-op fixation | Ultrasound |
|---|---|---|---|---|
| Kudzaev Kudzaev & Kraiushkin | PRS Global Open, 2021-07 10.1097/GOX.0000000000003680 | ~2 cm incisions along the scapular line | Corset ~2 months | Not central to the technique |
| RibXcar Manzaneda Cipriani et al. | PRS Global Open, 2023-12 10.1097/GOX.0000000000005499 | No incision: needle puncture | Corset | Yes: ultrasound guides the monocortical fracture |
| UUAIST Oñate Valdivieso et al. | PRS Global Open, 2024-01 10.1097/GOX.0000000000005513 | Two asymmetric 3–4 mm incisions | Corset | Yes: real-time ultrasound |
| RIBOSS Aguilar Villa et al. | Plastic and Reconstructive Surgery, 2024-05 10.1097/PRS.0000000000011512 | 2–3 cm incision | Titanium plates (osteosynthesis) | Palpation and/or ultrasound for marking |
| WASP Hoyos et al. | Aesthetic Surgery Journal Open Forum, 2025-05 10.1093/asjof/ojaf044 | Puncture, parallel approach | Corset 3–4 months | Yes: ultrasound |
Sources: the original articles linked by DOI and the technique summary in the supplementary material of the global survey published in PRS Global Open (10.1097/GOX.0000000000007609). Publication dates per Crossref.
Glossary
- RibXcar
- Incisionless rib remodeling: ultrasound-guided monocortical fracture of ribs 10–12 through a puncture, using an adapted piezotome ("Manzaneda's Tool"). Created by Dr. Raúl Manzaneda Cipriani. 10.1097/GOX.0000000000005499
- Kudzaev
- Waist narrowing without rib removal described by Kudzaev and Kraiushkin: greenstick fracture of ribs 11 and 12 through short incisions, followed by a corset. 10.1097/GOX.0000000000003680
- RIBOSS
- Rib osteotomy with osteosynthesis stabilization (Aguilar Villa et al.): rib osteotomy through an incision, stabilized with titanium plates. 10.1097/PRS.0000000000011512
- UUAIST
- Ultrasonic- and ultrasound-assisted indentation surgery of the thorax (Oñate Valdivieso et al.), based on Kudzaev's: piezotome corticotomy through two asymmetric incisions, with real-time ultrasound. 10.1097/GOX.0000000000005513
- WASP
- Waistline Aesthetic Slimming by Puncture (Hoyos et al.): monocortical fracture by puncture with a parallel approach and ultrasound. Its article cites RibXcar as prior work. 10.1093/asjof/ojaf044
What sets RibXcar apart
Narrowing the waist without removing ribs has published antecedents, and we acknowledge them. What is specific to RibXcar is the combination of incisionless access, ultrasound guidance, a dedicated instrument (Manzaneda's Tool, 2024) and a standardized protocol with its own body of evidence. See the RibXcar timeline and the full evidence.
Related: rib remodeling surgery · durability · course · timeline.
Frequently asked questions
What is the difference between RibXcar and WASP?
Both work through a puncture with ultrasound. RibXcar was published in December 2023 (PRS Global Open); WASP in May 2025 (Aesthetic Surgery Journal Open Forum), and its article cites RibXcar as prior work.
What is RIBOSS?
RIBOSS (rib osteotomy with osteosynthesis stabilization) is an incision-based rib osteotomy technique that fixes the ribs with titanium plates, published in Plastic and Reconstructive Surgery in 2024.
What is the Kudzaev technique?
It is the waist narrowing technique without rib removal described by Kudzaev and Kraiushkin in PRS Global Open (2021), using a greenstick fracture through short incisions and a postoperative corset.
What was the first incisionless, ultrasound-guided technique?
By the publication record, RibXcar, by Dr. Raúl Manzaneda Cipriani, published in PRS Global Open in December 2023.
Informational page for professionals. It summarizes what each published article describes; it is not medical advice or a comparison of clinical outcomes.