RibXcar

The high iliac crest: the other half of the waist

The waist is not defined by the ribs alone. The iliac crest — the upper border of the hip bone — matters too. When it sits high, the gap between the last rib and the hip is short and the waist looks straight no matter how much work is done above it. XCREST is the published technique to reduce that crest and lengthen the transition. In 200 patients, the waist went from 83.11 cm to 72.06 cm at six months.

"Treatment of the High Iliac Crest With Iliac Crest Reduction (XCREST)"
Raúl M. Manzaneda Cipriani — Aesthetic Surgery Journal 2025

Why this sits on a site about ribs

Because both measure the same distance from opposite ends. Rib remodeling shortens the upper border; XCREST lowers the bottom one. The study itself uses the distance between the last palpable rib and the iliac crest as an outcome — exactly the gap that visually defines a waist.

In this work that distance increased by an average of 3.8 cm. Same anatomical goal, approached from the hip.

The numbers

MeasuredResult
Patients200 women
Waist before surgery83.11 cm
Waist immediately after72.31 cm
Waist at 6 months72.06 cm
Last rib ↔ iliac crest distance+3.8 cm
Complications10% with pain lasting under 2 months, treated

The most telling figure is not the reduction but that it held: between the immediate postoperative period and six months the waist barely moved (72.31 → 72.06 cm). This is not swelling that later disappears.

What must be said about this study

It is a single-author case series, and that author created the technique. It describes what happened in 200 patients he operated on; it is not a comparative trial nor independent work. And the 10% pain-related complication rate is in the abstract itself: it is not a small figure and it belongs here.

See all the published evidence