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Body Contouring

Rib Removal
A rare procedure for very specific candidates and why alternatives often deliver better results.

Rib removal surgery can narrow the waist by removing the lower floating ribs. However, this procedure carries significant risks and limitations that make it unsuitable for most patients. Dr. Neavin believes in honest education: for the vast majority seeking an hourglass figure, liposuction with fat transfer to the hips delivers superior results with far less risk. This page explains both options so you can make an informed decision.
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Duration 2-3 Hours
Anesthesia General
Downtime 1-2 Weeks
Results Permanent
On This Page

Understanding Rib Removal Surgery

Permanent Structural Change

Removing the lower floating ribs creates a permanent narrowing of the waist at the skeletal level the ribs do not grow back.

Ideal for Flared Ribs

Patients with prominently flaring lower ribs can see dramatic improvement in their waist contour from rib removal.

Combined with Liposuction

When appropriate, rib removal can be combined with liposuction of the waist for enhanced contouring results.

One-Time Procedure

Unlike non-surgical treatments, rib removal is a single procedure with permanent results for suitable candidates.

Expected Results

Results from rib removal surgery depend heavily on your starting anatomy. Patients with flaring ribs can see noticeable waist narrowing. However, most patients achieve more dramatic hourglass results through liposuction with fat transfer—Dr. Neavin will help you understand which approach is best for your body.

Waist Narrowing (For Appropriate Candidates)

In patients with flaring lower ribs, removal creates a measurable narrowing of the waist. The degree of change depends on rib anatomy and how prominently the ribs contributed to waist width.

Permanent Skeletal Change

Once removed, the floating ribs do not regenerate. For suitable candidates, the structural change to the waist is permanent.

Visible Scarring

Scars from rib removal are 4-6 cm on each side and are not easily concealed. Patients must accept this trade-off. Scars typically fade over time but remain visible.

Technical Specifications

Rib Removal Surgery: What's Involved

Understanding the technical aspects of rib removal helps patients appreciate both its potential and its limitations. Dr. Neavin provides this information so you can make a fully informed decision.

01

Which Ribs Are Removed

Rib removal for waist contouring targets the lower floating ribs—typically ribs 11 and 12, and occasionally rib 10. These are called “floating ribs” because they are not attached to the sternum (breastbone) at the front.

While these ribs do not directly protect the lungs or heart, they still serve as a protective shield for the kidneys and other abdominal organs. Removing them does eliminate some of this protection.

02

The Surgical Approach

Rib removal is performed through incisions on each side of the back, typically 4-6 cm in length. The surgeon carefully dissects down to the ribs, protecting surrounding structures, and removes the targeted rib segments.

The proximity to the pleura (the tissue covering the lungs) creates risk during this dissection. If the pleura is injured, chest tubes may be required, and hospital admission for observation becomes necessary.

03

Limitations of Rib Removal

The most important limitation is anatomical: rib removal only helps patients whose waist width is primarily caused by flaring ribs. In most patients seeking waist narrowing, the width comes from fat and soft tissue, not bone structure.

For these patients, removing ribs produces minimal visible change while still carrying significant surgical risks. This is why Dr. Neavin carefully evaluates each patient and often recommends alternative approaches.

04

The Superior Alternative: Liposuction + Fat Transfer

For most patients seeking an hourglass figure, liposuction of the waist combined with fat transfer to the hips produces far superior results with dramatically lower risk.

This approach removes fat from the waist (creating narrowing), then uses that harvested fat to augment the hips (creating curves). The result is a more dramatic waist-to-hip ratio than rib removal typically achieves. Scars are less than a centimeter, there is no risk to the lungs, recovery is faster, and the procedure is far less painful.

Patient Profile

Candidates

Ideal Candidates

  • Have prominently flaring lower ribs that create a wide waist appearance
  • Have minimal excess fat in the waist area (rib removal addresses bone structure, not soft tissue)
  • Have realistic expectations about results and understand the trade-offs
  • Accept visible scarring (4-6 cm on each side) in exchange for potential improvement
  • Are in excellent overall health with no conditions that increase surgical risk
  • Are non-smokers
  • Have been evaluated and confirmed as good candidates by Dr. Neavin

Not Ideal Candidates

  • Do not have flaring lower ribs (most patients seeking rib removal fall into this category)
  • Have excess fat around the waist that is the primary contributor to their shape
  • Would achieve better results with liposuction and/or fat transfer to hips
  • Are unwilling to accept visible scarring
  • Have unrealistic expectations about how much narrowing can be achieved
  • Have health conditions that increase surgical risk
  • Are smokers unwilling to quit
Body Contouring Assessment

Which Procedure Is Right for Your Waist?

Discover whether rib removal or liposuction with fat transfer will best achieve your hourglass goals.

Understanding Your Options

Many patients come to us interested in rib removal surgery. However, the vast majority achieve better results with liposuction and fat transfer—a safer procedure with more dramatic outcomes.

This assessment helps you understand your anatomy and which approach Dr. Neavin would likely recommend.

Question 1 of 6
Question 01

What bothers you most about your waist area?

Select the option that best describes your primary concern.

Excess fat or fullness
Love handles or soft tissue that won't go away with diet and exercise
My ribcage seems too wide
Even when lean, my lower ribs flare outward
Both fat and wide ribcage
I have excess fat AND feel my bone structure is wide
Need better waist-to-hip ratio
I want more curves at my hips for an hourglass shape
Question 2 of 6
Question 02

When you pinch the skin at your waist, how much can you grab?

This helps determine whether fat or bone structure is the primary contributor to your waist width.

More than an inch of tissue
I can grab a substantial amount of fat at my waist
About half to one inch
There's some tissue to grab, but not a lot
Very little—mostly skin over bone
I'm quite lean and can feel my ribs easily
Question 3 of 6
Question 03

Do your lower ribs visibly flare outward?

Look in a mirror from the front. Rib flare is when the bottom ribs angle outward rather than curving inward.

Visual Reference
Normal
Ribs curve inward
Flared
Ribs angle outward
Yes, prominently flared
My lower ribs clearly angle out, even at a healthy weight
Maybe slightly
There might be some flare, but it's subtle
No, they curve inward normally
My bone structure creates a natural waist shape
I'm not sure
I can't tell if my width is from ribs or soft tissue
Question 4 of 6
Question 04

Would you like more curves at your hips?

Many patients find that adding volume to the hips dramatically improves their waist-to-hip ratio—sometimes more than narrowing the waist alone.

Yes, I'd love more hip curves
I have hip dips or my hips are narrow compared to my waist
I'm open to the idea
I hadn't considered it, but it could help my shape
No, my hips are fine
I just want a narrower waist
Question 5 of 6
Question 05

How do you feel about visible scarring?

Rib removal requires 4-6 cm incisions on each side. Liposuction scars are under 1 cm and barely visible.

I strongly prefer minimal scarring
Visible scars would bother me significantly
I'd accept scars if truly necessary
If it's the only way to achieve my goals
Scarring doesn't concern me much
Results matter more than scar appearance
Question 6 of 6
Question 06

How do you weigh surgical risk vs. results?

Rib removal carries risk of lung injury requiring hospitalization. Liposuction with fat transfer is much safer.

Safety is my top priority
I want the safest effective option
Balance safety and results
I'll accept reasonable risk for the best outcome
Results matter most
I'm willing to accept higher risk if needed

Your Recommended Procedure

Based on your responses, Dr. Neavin would likely recommend...

Best Match for You

Liposuction with Fat Transfer to Hips

Based on your answers, your waist width appears to come primarily from soft tissue rather than bone structure. Liposuction with fat transfer will likely deliver dramatically better results than rib removal—with far less risk, smaller scars, and easier recovery.

Scar Size
Lipo + Transfer
< 1 cm (tiny)
Rib Removal
4-6 cm each side
Surgical Risk
Lipo + Transfer
Low
Rib Removal
Lung injury risk
Creates Hip Curves
Lipo + Transfer
Yes ✓
Rib Removal
No
Recovery Time
Lipo + Transfer
1-2 weeks
Rib Removal
2-4 weeks
Removes fat from waist + adds curves to hips
No risk of lung injury or chest tubes
Uses your own fat for permanent results
Dr. Neavin has perfected this technique
Schedule Your Consultation

Dr. Neavin will confirm your candidacy and create a personalized surgical plan during your consultation.

In-Person Evaluation Needed

You may have anatomy suited for rib removal, but Dr. Neavin must confirm.

Requires Evaluation

Possible Rib Removal Candidate

Based on your answers, you may have the specific anatomy (prominently flaring ribs with minimal fat) that could benefit from rib removal. However, this is rare—most patients who think they need rib removal achieve better results with liposuction and fat transfer.

Important: Only an in-person exam can confirm. Many patients are surprised to learn their waist width comes more from soft tissue than bone. Dr. Neavin may still recommend liposuction with fat transfer if it would deliver superior results for you.

Rib Removal Is Best For
Prominent rib flare with minimal fat
Lipo + Transfer Is Best For
Fat-based waist width (most patients)
Schedule Your Consultation

Dr. Neavin will give you his honest recommendation—even if that means suggesting a different procedure.

Estimated Investment
$15,000 - $25,000
Rib removal surgery is a specialized procedure with costs reflecting its complexity and the expertise required. The investment covers surgeon fees, operating room and facility fees, anesthesia, and all pre and post-operative care. Before committing to this investment, Dr. Neavin recommends patients consider whether alternative procedures might better achieve their goals. Liposuction with fat transfer to the hips often costs less while delivering more dramatic results with lower risk. Rib removal is considered elective and cosmetic, so insurance does not cover the procedure. Financing options are available through CareCredit and Prosper Healthcare Lending. During consultation, Dr. Neavin will provide an honest assessment of whether rib removal is right for you, and if not, what alternatives might better serve your goals.
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The Better Alternative: Liposuction with Fat Transfer

01

Why Most Patients Choose This Instead

For the vast majority of patients seeking an hourglass figure, liposuction of the waist with fat transfer to the hips delivers superior results. This approach addresses the actual cause of waist width (fat and soft tissue) while creating curves at the hips. Scars are less than a centimeter. There is no risk of lung injury. Recovery is faster and less painful. Results are typically more dramatic than rib removal. Dr. Neavin has perfected this technique over years of practice and recommends it as the first-line treatment for most patients seeking improved waist-to-hip proportions.

Surgery Day Journey

Pre-Operative Preparation

You'll arrive at the surgical facility and meet with the nursing team. Dr. Neavin will see you for final markings and to answer any last questions. The anesthesiology team will review your health history and explain the anesthesia plan.

Anesthesia

Rib removal is performed under general anesthesia. A board-certified anesthesiologist monitors you throughout the entire procedure, paying particular attention to respiratory function given the proximity of the surgery to the lungs.

The Procedure

The surgery typically takes 2-3 hours. Incisions are made on each side of the back, and the targeted ribs are carefully removed while protecting surrounding structures. The incisions are closed in layers.
The Artisan Promise

Comprehensive
Aftercare Support

Recovery from rib removal requires careful attention to post-operative instructions. Dr. Neavin's team provides comprehensive support throughout your healing journey.

Pain Management

Rib removal is a painful procedure, and adequate pain control is essential. You'll be prescribed oral pain medication to use as directed. Pain with breathing is common initially and typically improves significantly within the first week.

Activity Restrictions

Avoid twisting, bending, and lifting for several weeks. Sleep in the position recommended by Dr. Neavin. Gradual return to activity follows a specific timeline—pushing too fast can compromise healing and increase pain.

Follow-Up Schedule

You'll see Dr. Neavin multiple times during recovery: typically at 1 week, 2 weeks, 6 weeks, and 3 months. These appointments allow monitoring of healing, scar management guidance, and clearance for progressive activity.

Healing Timeline

Every patient heals differently, but this timeline offers a general guide for your return to daily life.

Days 1-7: Initial Recovery

The first week after rib removal involves significant discomfort, particularly with breathing and movement. Pain medication is essential during this period. You'll need to sleep in a specific position and avoid any twisting or bending motions. Limited activity is required.

Weeks 2-3: Progressive Healing

Pain begins to subside but remains present, especially with deep breathing or certain movements. You can gradually increase light activity but must avoid anything strenuous. Swelling and bruising continue to resolve. Most patients can return to sedentary work if their job allows.

Weeks 4-6: Returning to Normal

Most patients feel significantly better by this point. Light exercise may resume with Dr. Neavin's approval. Scars are still red and healing. You'll begin to see more of your final results as swelling continues to resolve.

Months 2-6: Final Healing

Full activity typically resumes by 6-8 weeks. Final results become apparent once all swelling has resolved. Scars continue to mature and fade over 12-18 months, though they remain permanently visible.

Safety &
Potential Risks

Rib removal surgery carries significant risks that patients must understand before considering this procedure. Dr. Neavin believes informed consent requires complete honesty about potential complications. For many patients, these risks are a primary reason to consider alternative procedures.

Important Considerations

  • Pleural Injury: The pleura (tissue covering the lungs) lies close to the ribs being removed. Injury to the pleura can cause pneumothorax (collapsed lung), requiring chest tube placement and hospital admission for observation. This is the most serious risk specific to rib removal.
  • Significant Scarring: Incisions are 4-6 cm on each side and are not easily concealed by clothing. Scars are located on the back/flank area and remain permanently visible, though they typically fade over time.
  • Loss of Protection: While the floating ribs don’t directly protect the heart or lungs, they do provide some protection for the kidneys and abdominal organs. Removing them eliminates this protective function permanently.
  • Limited Results: Many patients are disappointed to find that rib removal produces less dramatic change than expected. This is because their waist width was primarily caused by fat and soft tissue, not rib flare.
  • Infection: As with any surgery, infection is possible. The surgical site requires careful post-operative care.
  • Asymmetry: Perfectly symmetric rib removal is challenging. Some degree of asymmetry may occur.
  • Chronic Pain: Some patients experience chronic pain at the surgical site, particularly with certain movements or positions.
  • Nerve Damage: Nerves in the surgical area can be damaged, causing numbness or altered sensation.

Frequently Asked Questions

Am I a good candidate for rib removal?
Most patients who inquire about rib removal are not good candidates. The procedure is only effective for patients with prominently flaring lower ribs—a specific anatomical feature that is relatively uncommon. During consultation, Dr. Neavin will honestly assess your anatomy and recommend the approach most likely to achieve your goals.
Why do you recommend against rib removal for most patients?
Because for most patients, waist width comes from fat and soft tissue, not rib structure. Removing ribs in these patients produces minimal visible change while still carrying significant surgical risks. Liposuction with fat transfer typically delivers far superior results with much lower risk for these patients.
How does liposuction compare to rib removal for waist narrowing?
For most patients, liposuction of the waist with fat transfer to the hips produces more dramatic results than rib removal. It addresses the actual cause of waist width (fat), creates curves at the hips, involves tiny scars (less than 1 cm), has no risk of lung injury, requires easier recovery, and costs less. Dr. Neavin has perfected this approach and recommends it for most patients seeking an hourglass figure.
Where are the scars from rib removal surgery?
Incisions are located on each side of the back/flank area, typically 4-6 cm in length. These scars are not easily concealed by most clothing and remain permanently visible, though they do fade over time.
What are the main risks of rib removal surgery?
The most significant risk is injury to the pleura (the tissue covering the lungs), which can cause pneumothorax (collapsed lung) and require chest tube placement and hospital admission. Other risks include significant visible scarring, loss of some organ protection, chronic pain, nerve damage, infection, and disappointment with limited results.
Dr. Tim Neavin
The Artisan

Artistry Meets
Surgical Precision

Dr. Tim Neavin is known for his unwavering honesty with patients—even when that means recommending against a procedure they came in requesting. When it comes to rib removal surgery, Dr. Neavin takes a cautious, educational approach.

The reality is that very few patients are good candidates for rib removal. The procedure works best for individuals with flaring lower ribs, a specific anatomical feature that is relatively uncommon. For most patients seeking a more defined waist and hourglass figure, the risks of rib removal surgery outweigh the benefits.

Dr. Neavin has spent years perfecting liposuction of the waist combined with fat transfer to the hips—a procedure that creates more dramatic curves with minimal scarring, lower risk, and faster recovery. He believes patients deserve to understand all their options, including which approach will actually deliver the best results for their specific anatomy.

During consultation, Dr. Neavin will honestly assess whether rib removal might benefit you or whether alternative approaches would better achieve your goals. This transparency is central to how he practices.

Diplomate American Board of
Plastic Surgery
Philosophy "Surgery with
Symmetry"

Beverly Hills & Santa Barbara

Start Your Transformation

Schedule your private consultation with Dr. Neavin today.

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