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\u201cIt raises an interesting moral question\u2014should plastic surgeons do whatever a patient wants? Is this any different than giant breast implants or overinflated lips?\u201d<\/p>\n<\/div>\n<\/aside>\n
Critics of the procedure worry about the surgery\u2019s impact on the lungs over time: If rib removal can compromise breathing, could rib remodeling pose a similar risk? The rib cage does play a role in respiration by providing space for the lungs to fully expand. When you undergo a procedure that \u201cintentionally shrinks the lower portion of the chest wall, you\u2019re impinging on the space that the lungs are meant to have,\u201d Dr. Rubinstein explains. \u201cThe tighter you make it when attempting to pull in the waistline, the less space the lungs have for taking deep breaths.\u201d<\/p>\n
Dr. Turin likens the effect to inhaling deeply while wearing a corset or Spanx. \u201cIt can be done, but it\u2019s a bit harder than breathing unrestricted,\u201d he says. After surgery, he posits, a patient\u2019s pulmonary function tests could look a little different, but in his opinion, that slight change would be \u201crelatively immaterial to the majority of the population.\u201d Dr. Hadeed adds that \u201cthe lungs typically only extend down to about the 10th rib,\u201d and it\u2019s generally the 11th and 12th ribs that are repositioned.<\/p>\n
Dr. Teitelbaum argues that even a small loss of pulmonary function may, in fact, be meaningful\u2014\u201cdismissing it would be like saying a small heart attack is irrelevant for most people\u201d\u2014and that doctors should screen for and precisely analyze any potential changes by performing pulmonary function tests before and after rib remodeling to see how patients\u2019 lungs fare. \u201cThese things need to be known,\u201d he says. Presently, however, such testing isn\u2019t standard practice. None of the surgeons I spoke to who perform rib remodeling do these before-and-after pulmonary tests, maintaining that they\u2019re unwarranted.<\/p>\n
Overall, data is lacking. \u201cRib remodeling hasn\u2019t been around that long, so there are few studies even looking at the techniques and results, let alone pulmonary function and the dynamics of breathing as it relates to the changes these operations make,\u201d says Dr. Rubinstein. I did find one study from 2024 detailing a remodeling treatment for \u201cwinged ribs\u201d (a medical condition where the ribs visibly and palpably protrude from the chest). Surgeons reduced the ribs from the front of the body (versus the lower back, as is customary) and conducted pulmonary tests on patients pre- and post-op. They recorded no significant changes in lung function six months after surgery. (With the approach for winged ribs, surgeons are working in \u201cmuch closer proximity to the lungs\u201d than they are during traditional rib remodeling,\u201d Dr. Hadeed says.)<\/p>\n\n\n
\u201cThere may come a time in the not-so-distant future when this is just another procedure that we do.\u201d<\/p>\n<\/div>\n<\/aside>\n
While Dr. Rubinstein has concerns about rib remodeling, he doesn’t dismiss the procedure out of hand. \u201cI think there\u2019s a role for almost everything in the right circumstances\u2014if the patient can be well informed of the risks and if the procedure can be done with a high enough level of safety and satisfaction,\u201d he says. Looking ahead, he adds, \u201cthere may come a time in the not-so-distant future when this is just another procedure that we do.\u201d The BBL seemed exotic 20 years ago, he reminds me, but today it\u2019s performed routinely in ORs across the country.<\/p>\n
Dr. Teitelbaum thinks the emergence of rib remodeling raises \u201can interesting moral question\u2014should plastic surgeons do whatever a patient wants, however ludicrous? Is this any different than giant breast implants or overinflated lips?\u201d<\/p>\n
But then there\u2019s this question: Who defines \u201cludicrous\u201d?<\/p>\n
For now, says Dr. Rubinstein, \u201cI\u2019m sitting back and waiting to see how rib remodeling pans out before I start offering it to my patients. I am one who thinks it\u2019s a long run for a short slide.\u201d<\/p>\n
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