TEMPORARILY WITHDRAWN: Fatal Complications Associated With Rib Remodeling: A Multinational Patient-safety Case...

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Patient Safety

Background:

• Rib remodeling techniques for waistline reduction are popular in aesthetic surgery.
• Piezotome-assisted rib puncture (RibXcar) is promoted as a minimally invasive alternative.
• Previous literature suggested low complication rates based on surgeon surveys.

Purpose of the Study:

• To report fatal complications associated with the RibXcar technique.
• To analyze potential mechanisms contributing to mortality.

Main Methods:

• Retrospective patient-safety case series from Latin America (2023-2025).
• Involved adverse event reports and medico-legal documentation.
• Validated by surgical associations (AMCPER, SCCP) and expert witnesses.

Main Results:

• Six deaths linked to RibXcar technique across Peru, Ecuador, and Mexico.
• Patient age range: 23-42 years.
• Causes of death included pulmonary thromboembolism, visceral injury, and respiratory failure.
• Deaths occurred between 4 hours and 70 days post-procedure.

Conclusions:

• This report documents fatal complications contradicting previous safety claims.
• Concerns raised about the biomechanical safety of non-visualized rib puncture.
• Increased scrutiny, standardized training, and risk assessment are crucial before wider adoption.