The RibXcar Technique for a pinched waistline - The Future of Waist Contouring?

In this blog…

What is the RibXcar Procedure?
How Does RibXcar Work?
RibXCar Before & After Photos – Amazing results
Benefits of RibXcar
Who is a Good Candidate for RibXcar?
Recovery and Aftercare
Risks and Considerations
List of Surgeons Offering the RibXcar Technique
PLASTIC SURGEONS performing RibXcar
Comparing RibXcar to Other Waist-Slimming Procedures
Cost and Availability
FAQs about RibXcar Procedure
Medical References for RibXcar Procedure

For centuries, achieving a defined or pinched waistline has been a beauty goal for many. From corsets that reshaped the torso to surgical rib removal, people have sought ways to create a slimmer, more contoured midsection.

However, traditional methods of rib remodelling like rib removal often come with drawbacks – painful recovery, scarring, and even irreversible structural changes.

The RibXcar technique is a revolutionary new method performed by plastic surgeons that can give you a slimmer waist without the need for major surgery or ugly scars. Described recently by one plastic surgeon as “this could be a bigger innovation than liposuction“

Developed by Dr Raúl M. Manzaneda Cipriani in 2022, this technique uses ultrasound to subtly reshape the lower ribs without removing them. Unlike rib removal surgery, which permanently takes out bone, RibXcar preserves the rib cage while creating a slimmer waistline through precise, controlled remodeling.

Since its introduction, this innovative technique has gained attention from top plastic surgeons worldwide, offering a new option for patients seeking a defined silhouette without the risks of invasive surgery. But how does it work? Who is it for? And what makes it different from other body contouring procedures like BBL, Rib Revolution and Liposuction?

Let’s take an in-depth look at RibXcar, from how it’s performed to its benefits, risks, and comparisons to other methods like rib removal, liposuction, and corset training.

What is the RibXcar Procedure?

The RibXcar procedure is a minimally invasive surgical technique designed to refine the waistline by reshaping the lower ribs without removing them. Unlike traditional rib removal surgery, which involves permanently extracting bones, RibXcar uses ultrasound guidance to reposition the 10th, 11th, and 12th ribs inward, creating a more sculpted, defined, pinched waistline.

An Alternative to Rib Removal

Historically, those seeking a dramatic waist reduction had limited options. Corset training offered temporary results, while rib removal surgery, a highly invasive procedure, came with significant risks, scarring, and an irreversible alteration of the ribcage. RibXcar represents a modern alternative that allows for a natural-looking, permanent waist contouring effect without the need for major surgery.

By using precise, ultrasound-guided techniques, surgeons can modify the curvature of the lower ribs with a tiny puncture incision (less than 1mm), making RibXcar a scar-free procedure. The technique preserves the structural integrity of the rib cage while achieving the aesthetic goal of a smaller waist.

Key Differences Between RibXcar and Rib Removal Surgery

RibXcar provides a safer, more precise approach to waist reduction, appealing to individuals seeking natural-looking results without the risks associated with rib removal surgery.

Feature	RibXcar Procedure	Traditional Rib Removal
Invasiveness	Minimally invasive (small puncture)	Highly invasive (large incision)
Scarring	No visible scars	Significant scarring
Bone Removal	No bones removed (reshaped only)	Ribs permanently removed
Recovery Time	2-3 weeks	Several months
Structural Impact	Preserves ribcage function	Alters ribcage permanently

Who Invented RibXcar and When?

The RibXcar procedure is a relatively new innovation in body contouring, developed by Dr. Raúl M. Manzaneda Cipriani, a plastic surgeon based in Lima, Peru. Recognising the limitations of traditional rib removal surgery, he sought a safer, less invasive alternative that could provide dramatic waist-slimming results without permanent structural changes to the ribcage.

The first RibXcar procedures were performed between October and December 2022 in Peru, Colombia, and Mexico by three board-certified plastic surgeons trained in both ultrasound technology and the monocortical fracture technique. Since then, the method has gained international attention and is now being adopted by plastic surgeons worldwide who specialise in waist refinement and torso sculpting.

With growing demand for body contouring solutions that prioritise natural-looking results and minimal downtime, RibXcar is emerging as a preferred choice for individuals looking to refine their waistline without undergoing major surgery.

How Does RibXcar Work?

If you’re considering waist remodelling, you might be wondering how RibXcar actually works. Unlike traditional rib removal, which physically removes parts of your ribcage, RibXcar modifies the position of your lower ribs using a precise, minimally invasive technique.

Here’s what you can expect during the procedure:

1. Ultrasound Mapping

Before anything else, your surgeon will use ultrasound technology to carefully map out the 10th, 11th, and 12th ribs. This ensures that only the necessary adjustments are made while maintaining the structural integrity of your ribcage.

2. Tiny Incision (Less Than 1mm)

Unlike traditional surgeries that require large cuts, RibXcar involves a tiny puncture incision, often less than 1mm in size. This means no visible scarring once healed.

3. Bone Reshaping with an Ultrasonic Device

A specialised ultrasonic tool (such as a piezotome) is used to perform a monocortical fracture.
Instead of removing the rib, only the outer layer of the bone is fractured, allowing it to be repositioned inward for a slimmer waist.

4. Natural Repositioning

The adjusted ribs are gently repositioned to create a more defined waistline.
Because the bones remain intact, the ribcage retains its natural function while taking on a more sculpted appearance.

5. Post-Procedure Healing and Contouring

You’ll need to wear a compression garment for around 2-3 months to help stabilise the repositioned ribs and enhance the final result.
Over time, your body naturally remodels the adjusted ribs, securing them in place.

RibXCar Before & After Photos – Amazing results

You can see RibXcar before and after photos on the websites and social media of RibXcar surgeons listed below.

Benefits of RibXcar

The RibXcar procedure has gained popularity for its ability to refine the waistline without the risks and invasiveness of traditional rib removal. Here’s why RibXcar is becoming a preferred choice for waist sculpting:

Scarless Approach

One of the biggest advantages of RibXcar is its minimally invasive nature. Instead of requiring large incisions, the procedure is performed through a tiny puncture (less than 1mm), meaning no visible scarring. Unlike rib removal surgery, which can leave noticeable marks along the torso, RibXcar’s approach allows for a smooth and natural-looking result.

Faster Recovery

Since RibXcar does not involve removing bones, recovery time is significantly shorter compared to rib removal surgery. Most patients can return to light activities within two to three weeks, while full recovery generally takes a few months with minimal discomfort. Wearing a compression garment helps stabilise the adjusted ribs, allowing the body to naturally adapt to the new shape.

Preserves Ribcage Integrity

Unlike traditional methods that require permanent rib removal, RibXcar reshapes the ribs without affecting their function. The 10th, 11th, and 12th ribs are carefully adjusted using a monocortical fracture technique, allowing them to be repositioned inward while keeping the ribcage intact. This prevents long-term complications associated with removing ribs, such as reduced torso support or structural weaknesses.

Highly Precise

The use of ultrasound guidance ensures that the RibXcar procedure is performed with exceptional accuracy. By mapping out the exact position of the ribs, surgeons can control the reshaping process while avoiding damage to surrounding tissues. This precision reduces the risk of asymmetry, uneven results, or unnecessary bone modification.

Suits Multiple Aesthetic Goals

RibXcar is a versatile procedure that caters to a wide range of patients. It is commonly used for waist sculpting in women who want a narrower waistline, but it is also a popular choice for transgender individuals seeking torso feminisation. By subtly adjusting the ribcage, the procedure helps create a more contoured and harmonious body shape, making it an inclusive option for various aesthetic goals.

Who is a Good Candidate for RibXcar?

If you’re considering scarless rib remodelling, you might be wondering whether RibXcar is the right option for you. While this minimally invasive technique offers a scar-free way to refine your waistline, the effectiveness of the procedure depends on factors like your anatomy, health, and overall body composition.

Ideal Candidates for RibXcar

Models, Body Artists, and Influencers – Many individuals in the entertainment and social media industries, including online performers, waist-training enthusiasts, and alternative models, seek a dramatic and highly sculpted look. RibXcar can provide a permanent waist-slimming effect, making it a popular choice among influencers, online models, and those who rely on aesthetic appeal for their profession.
Aesthetic Patients wanting an Hourglass Shape – This includes individuals with body shapes such as apples, pears, and triangles, as well as those who are barrel-chested or have a naturally straight waistline.
Cisgender Women – Some women naturally have rib structures that limit their curves, preventing them from achieving their desired waist-to-hip ratio. RibXcar can help enhance waist definition, particularly in those with a straighter or less-defined torso.
Transgender Patients – Individuals Assigned Male at Birth (AMAB) Seeking Torso Feminisation – RibXcar is particularly beneficial for transgender women and non-binary individuals who want a more feminine waistline. Many AMAB individuals have a wider thorax and splayed ribs, making it challenging to achieve a curvier silhouette through traditional methods like liposuction alone. RibXcar allows for a subtle yet permanent waist remodelling to help create a smoother, hourglass shape.

To help you determine if RibXcar is right for you, here’s a detailed comparison of ideal candidates, borderline cases, and those who may not be suitable for the procedure:

What If You’re Unsure?

If you fall into the “possible candidate” category, a consultation with a plastic surgeon will help determine whether RibXcar is right for you. In some cases, combining liposuction or non-surgical body contouring may enhance results if rib adjustments alone are not enough.

Recovery and Aftercare

One of the key advantages of the RibXcar procedure is its relatively quick recovery time compared to more invasive body contouring techniques like rib removal surgery. However, as with any surgical procedure, proper aftercare is essential to ensure the best possible results and a smooth healing process.

Expected Downtime

Most patients can expect to take two to three weeks off from strenuous activities following the RibXcar procedure. While the technique is minimally invasive, the ribs still need time to stabilise in their new position. During the initial recovery phase, you may experience some discomfort, swelling, and bruising, but these symptoms generally subside within a few weeks.

A compression garment is a critical part of the post-operative care routine. You’ll need to wear it for at least two to three months, as it helps support the newly adjusted ribs, reduces swelling, and ensures the waist maintains its contoured shape during the healing process. Most surgeons recommend wearing the garment full-time for the first few weeks, gradually transitioning to only wearing it during the day as recovery progresses.

While light movement is encouraged to promote circulation and prevent complications, heavy lifting, intense exercise, and excessive twisting of the torso should be avoided for at least six weeks.

Potential Side Effects

Because RibXcar is less invasive than rib removal, the risk of severe complications is lower. However, there are still some temporary side effects to be aware of:

Swelling and Bruising: It is normal to experience some mild to moderate swelling around the treated area, which can last for several weeks. Applying cold compresses and keeping the torso elevated while resting can help manage swelling.
Mild Discomfort: Most patients report that the pain levels are much lower compared to traditional rib removal. The sensation is often described as a dull ache or pressure, rather than sharp pain. Over-the-counter pain relief or mild prescription medication can help manage any discomfort.

These side effects are temporary and should gradually improve within the first two to four weeks.

Long-Term Results

One of the biggest benefits of RibXcar is that the waist reduction is maintained over time as the ribs heal in their new position. Unlike corset training, which only provides temporary compression, RibXcar permanently reshapes the lower ribs.

Over the course of three to six months, the bones naturally remodel and stabilise, meaning that the new waist contour remains even after the healing process is complete. With proper post-operative care, final results can be long-lasting and provide a natural-looking, slimmer waistline without the need for major surgery.

Risks and Considerations

RibXcar still involves surgical adjustments to the rib structure, meaning there are some risks and considerations to keep in mind.

Organ Safety and Lung Function

One of the most common concerns about rib contouring is whether it affects organ function or breathing. RibXcar specifically targets the 10th, 11th, and 12th ribs, which are below the lungs, meaning lung function remains completely unaffected. This technique preserves ribcage stability while allowing for aesthetic improvements. Additionally, the positioning of these ribs ensures that vital organs such as the heart and liver remain protected, reducing the risk of complications. The use of ultrasound guidance further enhances safety by allowing precise adjustments while avoiding unintended structural changes.

Bone Healing Issues

Since RibXcar involves adjusting the lower ribs through a controlled fracture technique, the healing process is crucial to maintaining the final results. If post-operative care instructions are not followed properly, there is a risk that the ribs may not heal in the desired position.

To avoid complications:

Wearing the compression garment consistently is essential to stabilise the ribs as they heal.
Avoiding excessive twisting or bending of the torso can prevent unintentional shifts in rib positioning.
Following all post-operative appointments ensures that the healing process is progressing correctly.

Most patients heal without issues, but in some rare cases, improper healing could lead to minor asymmetry or less defined results than expected.

Temporary Discomfort Due to Rib Adjustments

Although less painful than rib removal, RibXcar still involves modifying bone structure, meaning some temporary discomfort is to be expected. Patients commonly report:

A sensation of tightness or pressure around the waist.
Soreness when moving or stretching during the first few weeks.
Mild stiffness while the ribs adjust to their new position.

This discomfort gradually decreases as the body heals, typically resolving within a few months.

Limited Studies and Long-Term Research

Because RibXcar is a newer technique, long-term studies on its effects are still limited. While early results have been promising, ongoing research will help determine:

How the procedure holds up over decades as the body naturally changes with age.
Potential long-term effects on rib flexibility and overall torso structure.
Comparative studies between RibXcar and traditional rib removal to better understand patient satisfaction and safety.

For now, early patient experiences and short-term results have been highly positive, but if you’re considering RibXcar, it’s important to consult with an experienced plastic surgeon who understands the latest advancements in the procedure.

List of Surgeons Offering the RibXcar Technique

Since its introduction in late 2022, the RibXcar procedure (not RibXScar) has gained interest from leading plastic surgeons across the world. It has become particularly popular among body contouring specialists who focus on waist remodelling and torso feminisation. While the technique is still relatively new, several highly skilled surgeons have begun offering RibXcar to patients seeking a sculpted waistline.

Below are some of the notable plastic surgeons currently performing the RibXcar procedure.

PLASTIC SURGEONS performing RibXcar

Plastic surgeons who have been trained in the innovative new RibXcar technique can be found in Europe, USA and South America. At this time there are none in the UK or Australia.

Dr. Alexis Delobaux (France)

📍 Paris, France
🌐 Website: Dr Alexis Delobaux

Dr Alexis Delobaux is a leading French plastic surgeon specialising in high-end body sculpting procedures. Based in Paris, he has been performing innovative aesthetic techniques, including hi-definition liposuction, abdominal etching, and waist contouring.

He was one of the first European plastic surgeons to perform RibXcar and is known for offering the procedure to high-profile clients, models, and individuals looking for subtle yet effective waist remodelling. Dr Delobaux emphasises the minimally invasive nature of RibXcar, highlighting how it provides dramatic results with no visible scarring.

Many of his patients combine RibXcar with advanced fat grafting and body reshaping techniques to achieve a harmonious, natural-looking silhouette. He is a founder of the Body Contouring Academy.

Dr Sidhbh Gallagher (USA)

📍 Miami, Florida, USA
🌐 Website: Gallagher Plastic Surgery

Dr Sidhbh Gallagher is a plastic surgeon based in Miami, best known for her expertise in gender-affirming surgeries and body contouring procedures. She was one of the early adopters of RibXcar in the United States, recognising its benefits for waist sculpting and torso feminisation, particularly for transgender women and non-binary individuals seeking a more defined waist.

Dr Gallagher integrates RibXcar with other body sculpting procedures, such as liposuction and VASER liposculpture, to enhance results. Her focus on precision and safety makes her a sought-after choice for patients looking for a scarless, permanent waist reduction technique.

Dr Thomas Sterry (USA)

Watch his RibXCar thread

📍 New York, New York, USA
🌐 Website: drsterry.com

Dr. Thomas P. Sterry has always aspired to be the best plastic surgeon in NYC, and since the beginning of his career, he has been building that reputation. He understands that if the women and men he treats look fabulous, other patients will follow them to his boutique plastic surgery practice in Manhattan. That means creating results using the advanced techniques he teaches to residents as a clinical assistant professor of plastic surgery at Mt. Sinai Medical Center in New York City.

Dr César Aguiluz (USA)

📍 Rancho Cucamonga, California, USA
🌐 Website: Gemini Plastic Surgery

Dr César Aguiluz is a board-certified plastic surgeon in California, specialising in body sculpting and aesthetic surgery. His clinic, Gemini Plastic Surgery Aesthetic & Laser Center, offers RibXcar as part of a comprehensive body contouring approach.

Dr Aguiluz has played an important role in bringing RibXcar to the West Coast, making it available to patients who want a more defined waist without traditional rib removal surgery. His expertise in liposuction, tummy tuck – abdominoplasty, and waist reduction surgeries allows him to customise RibXcar for both men and women, tailoring the procedure to suit individual body structures.

Athena Plastic Surgery Clinic (Taiwan)

Location: Taipei, Taiwan
Background: The clinic offers the RibXcar technique, referred to as the “Seamless Barbie Waist,” utilizing ultrasound-guided minimally invasive rib sculpting.

Services: Provides rib remodeling to achieve a slimmer waistline with minimal scarring and faster recovery times.

Dr Zamir Paez (Latin America and Dubai)

📍 Colombia & Dubai

🌐 Website: Dr Zamir Paez

An internationally acclaimed plastic surgeon based in Medellín, Colombia, Dr Paez is celebrated for his innovative surgical techniques and empathetic approach. He offers RibXcar among other body contouring procedures. In addition to his practice in Colombia, Dr Paez has extended his services to Dubai, operating at clinics accredited by the Joint Commission International.

As the popularity of RibXcar continues to rise, it’s anticipated that more surgeons and clinics worldwide will adopt this technique, expanding its availability to meet the growing demand for minimally invasive waist contouring solutions.

Comparing RibXcar to Other Waist-Slimming Procedures

If you’re considering waist contouring, you may be wondering how RibXcar stacks up against other popular waist-slimming methods. While traditional rib removal, liposuction, and corset training all aim to create a more defined waistline, they differ significantly in invasiveness, effectiveness, and long-term impact. RibXcar offers a minimally invasive, permanent solution that adjusts the rib structure without full removal, making it a unique alternative. The chart below provides a side-by-side comparison of these techniques, helping you understand which option might best align with your aesthetic goals and recovery preferences.

Vs. Traditional Rib Removal:
- Rib removal is more invasive, irreversible, and requires longer recovery.
- RibXcar is less invasive, preserves the ribs, and has minimal scarring.
Vs. Liposuction or Hi-Def Lipo:
- Lipo removes fat, not bone, so it cannot create the same structural waist narrowing.
- RibXcar modifies the rib shape, making it ideal for more dramatic sculpting.
Vs. Corset Training:
- Corsets offer temporary waist slimming but cannot change bone structure.
- RibXcar permanently reshapes the lower ribs.

Cost and Availability

Since RibXcar is a relatively new procedure, its cost and availability vary depending on location, surgeon expertise, and clinic reputation. As of now, the procedure is primarily offered by a select group of plastic surgeons in the USA, Europe, and South America.

How Much Does RibXcar Cost?

The average cost of RibXcar ranges from USD$10,000 to USD$20,000, depending on factors such as:

Surgeon’s experience – Highly skilled surgeons who specialise in waist sculpting and body contouring may charge at the higher end of the scale.
Geographical location – Clinics in major cities like Miami, Los Angeles, Paris, and São Paulo tend to have higher fees due to demand and clinic prestige.
Additional procedures – Some patients combine RibXcar with liposuction or high-definition body contouring, which can increase the total cost.
Post-operative care – Compression garments, follow-up appointments, and aftercare services may be included in the price or charged separately.

While RibXcar is more expensive than corset training or liposuction, it is considered a long-term investment for those seeking permanent waist contouring without full rib removal.

FAQs about RibXcar Procedure

How soon can I see the final results after RibXcar?

While you’ll notice some waist reduction immediately after the procedure, the final results typically take 3 to 6 months as swelling subsides and the bones fully heal in their new position. Wearing a compression garment during recovery helps enhance and maintain the outcome.

Can RibXcar be combined with other body contouring procedures?

Yes! Many patients choose to combine RibXcar with liposuction, high-definition lipo, or fat grafting for enhanced body sculpting results. If you’re undergoing multiple procedures, your surgeon will design a custom treatment plan to achieve the best proportions.

Does RibXcar affect flexibility or movement in the torso?

No, since the lower floating ribs are adjusted and not removed, RibXcar does not limit flexibility or movement. After healing, you’ll be able to bend, twist, and engage in physical activities as you normally would.

Can RibXcar be reversed if I change my mind?

No, the adjustment to the ribs is permanent as the bone heals in its new shape. However, because the ribs are not removed, the natural structure of the ribcage remains intact, and any long-term concerns should be discussed with your surgeon before the procedure.

Will the procedure change how my waist looks when I gain or lose weight?

Your waist shape will remain more defined even if your weight fluctuates. However, significant weight gain can alter the overall proportions of your torso, while weight loss may further enhance the contoured effect. Maintaining a stable weight helps preserve your results.