Doç. Dr. Hasan Ersöz
- Jan 11
- 9 min read

Waist Narrowing (Reduction) Surgery -Rib Removal Surgery (Repositioning) -

Updated: Jan 18

Waist Narrowing (Reduction), Rib Removal Surgery Surgery

Rib Removal Surgery, commonly known as Waist Narrowing, represents a specialized body contouring procedure designed to alleviate internal anatomical constraints, facilitating horizontal reduction of the waistline.

When conventional approaches such as non-surgical methods (comprising diet, exercise, and waist training) or surgical interventions like liposuction and tummy tucks fall short in achieving the desired level of waistline reduction, the option of rib removal surgery becomes a viable consideration.

Understanding the rationale behind rib removal involves recognizing the impact of ribs #11 and #12 on the waistline. By applying gentle pressure to your own waist, these free-floating ribs become palpable.

Unlike their counterparts above, these ribs exhibit a distinct downward angulation, remaining unattached to muscles and fascia. Functioning as crucial elements in providing outward support to the waistline's structure, these ribs contribute to its shape.

Consequently, modifying the outer segments of ribs #11 and #12 can induce a collapse of the waistline, resulting in a more inward contour and a reduction in circumferential measurements.

In essence, rib removal surgery aims to address limitations imposed by these specific ribs, fostering a transformative impact on the aesthetics of the waistline. When conventional means prove insufficient, this specialized procedure becomes an avenue for achieving the desired waistline narrowing and enhancing overall body proportions.

First of all, I should point out that what I am talking about are aesthetic issues. Since the tastes of individuals cannot be discussed, as there are exceptions to every situation, the issues I will talk about, especially in this aesthetic issue, are generally socially accepted norms.

I am making these explanations in order to respond to these requests of individuals who only want to get a thinner waist. Those who think otherwise will not take this approach anyway and we have infinite respect for them.

Why is low waist circumference so important?

As is widely known, waist circumference is directly related to a person's health. Especially in cardiovascular health, insulin resistance and oxidative stress, waist circumference is very important.

For this reason, an average waist circumference of 94 cm or less for men and 80 cm or less for women are ideal waist circumference values. When it is 102 cm or more for men and 88 cm or more for women, it means that the danger bells are ringing for these individuals in terms of health.

Instinctively, those with a narrow waist circumference are always attractive to the opposite sex. This is because our instincts understand that a low waist circumference is an indirect indicator of health and reproductive success in the opposite sex.

This is because our instincts are designed to survive and continue our lineage by having quality children. The key to having a quality child is to choose the best quality mate, both physically and in terms of personality and character. It is to pass on the quality genes of that mate to the child to be born.

In short, a low waist circumference is the most basic indicator of good health and a factor of sexual attractiveness for both sexes.

What are the Anatomical Differences in Waist Circumference in Men and Women?

In men, the broad shoulders and chest parts of the body provide an aesthetic appearance as a sign of strength. However, a proportionate thin waist provides an inverted triangle with the base facing upwards and creates the aesthetic image we call the triangle body.

However, too many broad shoulders in women spoil the feminine elegance and do not give a desired image with the social aesthetic understanding.

For women, a body in the shape of a tea cup, which is used in Turkey, is considered more aesthetic. In other words, although there are not too many wide shoulders, the upper part of the body is a little wider, the waist is thinned as much as possible in a curved way, and then the expansion towards the hip area provides this image.

The triangular body is instinctively attractive to women because it is a sign of physical strength for the man and, as a result, of his ability to better protect his children and family from the elements and other adverse situations that may arise in the future.

The tea cup shaped body structure is also an indicator of fertility in women. Wide hips allow the embryo or fetus to grow in a more protected place, as the position of the uterus is more favorable.

Large breasts, on the other hand, are attractive to men because of the instinct that the woman can better nourish the child. I answered in the first question why the thin waist between these two widths is attractive.

In general, I would add that the anatomical features that distinguish each sex are attractive to the other.

For example, a man's facial hair or a woman's breasts are attractive to the opposite sex because the opposite sex does not have them. A man's body shape, which we call the "Triangle Body", and a woman's body shape, which is shaped like a "Tea Cup", are attractive to the opposite sex.

Since sexual attractiveness is one of the most important factors in the formation of the concept of aesthetics, these are the body types that are aesthetically accepted in general social norms.

What is the Reason Why Women Prefer Waist Slimming Surgery?

As I said, it is important for both sexes to have a low waist circumference. However, in men, this should be in the shape of an "inverted triangle", flat and gradually narrowing downwards, while in women, it is desired to narrow in the shape of a "tea cup", first in a curved way, and then expand as it goes lower down the waist and end with widened hips.

Waist thinning surgery through rib removal, which we perform, provides a curved narrowing in the upper part of the waist. Since we have not made any intervention on the lower part, the waist, which is more narrowed, expands with a sharper curve towards the hips. This helps to emphasize the desired "tea cup" appearance in women.

In men, it is stated in the literature that only those who have undergone sex reassignment surgery have undergone this surgery to provide a more feminine curve to their body.

Who Should Have This Surgery?

Of course, it should be performed by a thoracic surgeon. However, unfortunately, this issue is ignored and most patients are operated by plastic surgeons today, but I believe that this is not correct.

Today, when it comes to plastic surgery, the first thing that comes to patients' minds is to apply to a plastic surgeon. However, we actually need to look at it this way: When we think of bone trauma, fractures and other surgical diseases, which department comes to mind first? Of course, orthopedics.

However, sternum and ribs are bones that are not in the field of training and interest of orthopedists. This is because a rib fracture may have penetrated the lung, heart or other important chest organs, and the orthopedist's knowledge of internal organ surgery may be required beyond his/her knowledge of bones.

Therefore, if there is a rib fracture after trauma, thoracic surgeons, not orthopedists, deal with these patients.

Isn't that the purpose for which ribs were created? Ribs are the bone cage surrounding the most important and sensitive internal organs in the human body. Naturally, an intervention on the ribs is not considered appropriate by a physician who does not know how to intervene on internal organs.

For this reason, orthopedists are not interested in these rib and sternum diseases. For the same reason, plastic surgeons should not be interested either. I think that plastic surgeons who are interested in this subject are interested in this subject outside of their training curriculum and unauthorized and put patients at risk.

If, for example, while trying to remove these ribs, there is a small damage to the membrane of the lung called "pleura", which is located just inside the rib, he will have to call a thoracic surgeon to intervene. However, if the same situation occurs in the hands of a thoracic surgeon, he will be able to overcome this situation easily.

This is precisely why I strongly recommend that a thoracic surgeon perform this work without putting patients at risk.

Many breast surgeons state that they do not perform this operation. What is the reason?

As I mentioned in the question above, thoracic surgeons are not only interested in the ribs and sternum, which are the bones of the chest, but they are also physicians who have made it a principle to combat important life-threatening health problems such as lung cancers and thymus gland surgeries.

Removing the entire lung through a tiny hole with a robotic lung cancer surgery and giving the patient a healthier life is a priority for most of them. If the bones of the rib cage, which we call the chest wall, have not been injured as a result of trauma or have not caused a life-threatening condition such as a bone tumor, they may consider it unnecessary to perform such plastic surgery.

Most of them are not interested in deformities of the chest wall bones (pectus excavatum, pectus carinatum, pectus arcuatum, etc.), which are my special interest. There are those who think that it is wrong to intervene in them, especially if there is no such thing as the bone pressurizing the heart. However, even the scientific literature states that these conditions should be corrected only if the patient is uncomfortable with the appearance of the deformity.

I am in the minority of these breast surgeons. I can understand how important aesthetic and psychological concerns and self-confidence problems are for patients. For this reason, I can perform such aesthetic surgeries with peace of mind by respecting the patient. I think I help my patients in this way.

And think about it, don't you think it is much more appropriate for a surgeon who is capable of removing the patient's lung by tying all the vessels of the lung through a 3 cm incision to perform this rib surgery, which can be considered simple for him, than for a plastic surgeon to do this job?

I would also like to point out that, of course, I have the utmost respect for my colleagues who think differently than me on this issue, as well as for anyone who thinks otherwise.

How do removed ribs affect the patient's life?

Unlike other mobile bones, ribs only serve as a protective cage against internal organs. For this reason, a person whose ribs are removed only loses the protective function in that area, no other functional deficiency in the patient does not cause any change in his/her life.

Moreover, since the membrane of the removed bone will be carefully peeled off and the bone will be sutured end to end again after the bone is removed, the body will fill that area with bone again within a few months. In other words, the protective function of the rib will be restored.

Only this time, since the membrane of the bone will be sutured by giving the appropriate shape to the surrounding tissues, the newly formed bone will be formed in the shape of the membrane we shape, that is, narrow as we want, and the patient will of course continue to look aesthetically. In other words, the surgery provides a permanent result for life.

What are the Risks of Surgery?

As I said, the risks of this surgery are quite low if it is performed by a thoracic surgeon who is familiar with internal organ surgery. A thoracic surgeon can immediately intervene in any situation that may occur in this surgery.

Apart from that, I don't think I need to mention situations such as wound infection, which can occur in every surgery.

Which ribs are removed during surgery?

The free ribs, which we call the 11th and 12th ribs, are removed by making slightly diagonal incisions, which can vary between 2.5 and 5 cm in size, to be made at the 11th rib level from both back-side corners. With this intervention, if the surgeon does not find aesthetic correction sufficient according to the patient's condition, another piece can be cut out from the center of the 10th rib.

How many hours does the surgery take?

It takes an average of 1 hour for each of the right and left ribs, totaling 2-2.5 hours.

How long does the patient stay in the hospital after the surgery?

If the surgery was performed in the morning and everything is fine, the patient can be discharged in the evening or a one-night hospitalization after surgery may be sufficient.

Is There Any Condition to Be Considered After Surgery?

The body tends to accumulate edema fluid in the space left in place of the bones removed after surgery. For this reason, the patient will need to use a corset or bandage that tightly wraps the waist area for 1-2 months. Apart from this, there is no other condition that should be considered for this surgery.

Has anyone in the world of celebrities had waist narrowing surgery before?

There are names we all know who prefer the thin waist image, which is also accepted by societies for an aesthetic appearance, in the world of celebrities. We can come across both female and male celebrities who have undergone this surgery with the desire to have a thinner waist.

You can reach the celebrities who have undergone waist narrowing (rib removal) surgery here;