Costal Surgery for Waist Improvement Safety and Efficacy: A Systematic Review of the Literature.

Abstract

Background: Body contouring surgery has gained increasing popularity. Waist reduction has become central to body contouring, particularly in Latin America, where hip stylization is a beauty standard. This systematic review aims to evaluate the safety and efficacy of costal cosmetic surgery for waistline improvement and to assess the quality of the evidence.

Methods: Search Methods for Study Identification: A comprehensive search was conducted on PubMed and other databases using the following keywords: "Removal rib," "Remodeling Rib," "Waist narrowing," "Waist-hip ratio," "Body contouring," "Aesthetic surgery," "Plastic surgery" and "Complications."

Selection of studies: We included all studies regarding surgery on the ribs with the aim of improve (narrow) the waist for cosmetic purposes.

Results: Of the 161 studies identified, 8 met inclusion criteria. Most studies were retrospective case series, with two being multicentric. A total of 444 participants were included, predominantly women. Five studies involved costal remodeling, and three performed costal resection. Anthropometric outcomes were reported in 6 studies. Complications included pain, pneumothorax and wound dehiscence. Follow-up periods ranged from 3 to 6 months.

Conclusion: While rib resection and remodeling appear to be safe techniques, their long-term efficacy remains uncertain. Studies with rigorous designs and longer follow-up are needed to establish robust evidence.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .