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The Thoracic Cage: Ribs01:20

The Thoracic Cage: Ribs

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Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
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Updated: Jan 9, 2026

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Anterior Aesthetic Rib Cage Remodeling With Osteosynthesis.

Hugo Aguilar Villa1,2,3,4, Brian Ramírez5,6, Silvia J Villabona-Florez7

  • 1From the Colombian Society of Plastic, Aesthetic, Maxillofacial, and Hand Surgery, Bogota, Colombia.

Plastic and Reconstructive Surgery. Global Open
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The anterior aesthetic rib cage remodeling with osteosynthesis (ARCO) technique effectively reduces chest circumference and improves rib cage aesthetics. This body contouring procedure demonstrates high patient satisfaction and safety, with no adverse respiratory effects observed.

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Area of Science:

  • Plastic Surgery
  • Aesthetic Surgery
  • Thoracic Surgery

Background:

  • Body contouring is a growing trend in aesthetic plastic surgery.
  • Anterior thoracic cage deformities, particularly lower rib prominence, are common patient concerns.
  • The anterior aesthetic rib cage remodeling with osteosynthesis (ARCO) technique was developed to address these deformities.

Purpose of the Study:

  • To evaluate the efficacy and safety of the ARCO technique for anterior rib cage remodeling.
  • To assess changes in chest circumference and patient satisfaction after the ARCO procedure.
  • To investigate the impact of the ARCO technique on respiratory function.

Main Methods:

  • A retrospective study of 34 patients who underwent the ARCO procedure.
  • Measurement of rib cage perimeter pre- and post-operatively.
  • Spirometry, intraoperative monitoring of peak airway pressure and pulmonary compliance, and BODY-Q questionnaires for satisfaction assessment.

Main Results:

  • Significant reduction in inferior rib cage perimeter (mean decrease of 2 cm, P < 0.001).
  • Stable intraoperative peak inspiratory pressure and pulmonary compliance.
  • No restrictive changes in respiratory volumes observed during follow-up.
  • High patient satisfaction reported via BODY-Q.

Conclusions:

  • The ARCO technique is an effective method for reducing chest circumference and enhancing anterior rib aesthetics.
  • The procedure involves controlled fracture and osteosynthesis, ensuring stability and natural curvature.
  • The ARCO technique achieves high patient satisfaction with a low risk of complications and eliminates the need for postoperative corsets.