Anterior Aesthetic Rib Cage Remodeling With Osteosynthesis

Background: – Body contouring is an increasingly common trend in aesthetic plastic surgery. In the pursuit of ideal body proportions, anterior thoracic cage deformities, especially lower rib cartilage prominence have emerged as a frequent source of dissatisfaction. To address this concern, the anterior aesthetic rib cage remodeling with osteosynthesis (ARCO) technique was developed as an innovative method to reshape the anterior rib cage. Methods: – A retrospective study was conducted in Colombia on patients who underwent the ARCO procedure. Preoperative and postoperative rib cage perimeter measurements were recorded. Spirometry was performed preoperatively and during long-term follow-up to assess potential changes in respiratory volumes. Intraoperative peak pressure and pulmonary compliance values were monitored to evaluate procedural safety. Postoperative satisfaction was assessed using the BODY-Q questionnaire, and all complications were documented. Results: – A total of 34 patients were included, with a mean age of 34 years. A significant reduction in the inferior rib cage perimeter at the level of the eighth rib was observed (Mann-Whitney U =190, P < 0.001), with a mean decrease of 2 cm. Intraoperative peak inspiratory pressure and pulmonary compliance remained stable across all procedural stages. Spirometric analyses revealed no restrictive changes in respiratory volumes. Conclusions: – The ARCO technique offers an effective approach for reducing chest circumference and enhancing the aesthetic contour of the anterior rib margin while achieving high patient satisfaction. It involves a controlled greenstick fracture followed by osteosynthesis to create a stable and natural rib curvature, reducing the risk of malunion and eliminating the need for postoperative corsets.