The shape of a person’s silhouette influences how we perceive their gender identity. Beyond the face, gestures, or voice, the body contour—especially the waist-to-hip ratio—has a direct impact on one’s silhouette and personal confidence. When the body retains a wider rib cage or a less defined waist, even after hormone therapy or liposculpture, some trans women may still feel that their silhouette does not fully reflect who they are. In these cases, rib remodeling becomes an advanced option within body feminization surgery. Discover what rib remodeling is and what the procedure involves.
What Is Rib Remodeling?
Rib remodeling is a surgical procedure designed to refine the lower torso by subtly modifying the floating ribs—typically the eleventh and twelfth, and sometimes the tenth. This operation can be performed on both cis and trans women. The goal is not to remove ribs but to adjust their curvature and position to achieve a narrower, more stylized waist without compromising respiratory function or the integrity of the thoracic structure.
What Does Rib Remodeling Consist Of?
At IM GENDER, the technique is performed through controlled osteotomy. This means the surgeon makes a very precise cut using an ultrasonic saw – which protects soft tissues without damaging them – on the posterior portion of the selected ribs, which are then fixed in place with a small osteosynthesis plate. This fixation helps maintain the new shape during bone healing and reduces postoperative pain, supporting a more stable recovery.
The result is a smooth transition between the chest and abdomen, with a more defined, harmonious silhouette that is proportionate to the rest of the body – in other words, a feminized contour.
Benefits of Rib Remodeling
For trans women seeking to feminize their silhouette, rib remodeling allows them to:
- Redefine the waist, accentuating the curve toward the hips
- Provide structural femininity by modifying the bony base that shapes the body contour
- Complement other body surgeries such as flank liposuction or hip and buttock augmentation
- Achieve long-lasting, natural results, as it works on the bone structure rather than only fatty tissue
More than a cosmetic procedure, this is a body feminization surgery that can help align physical appearance with gender identity, strengthening confidence and well-being.
What Is the Procedure Like?
The surgery is performed under general anesthesia and lasts approximately two hours. It can also be combined with other body feminization procedures such as liposculpture or buttock lipofilling.
Small, discreet incisions are made on the flanks to access the lower rib area.
Using specialized instruments, the surgeon performs a controlled osteotomy on the selected ribs, adjusting their curvature to narrow the waist. A titanium plate is then placed to secure the new position and prevent shifting or discomfort during healing.
The incision is closed in layers to minimize scarring, and a compression garment is applied at the end of surgery, which must be worn during the first few weeks.
Recovery After Rib Remodeling
Most patients stay in the clinic for one night after the procedure. During the first few days, a feeling of tightness or mild discomfort in the treated area may occur, which is easily managed with medication.
Wearing the compression garment is essential during the following weeks, as it helps shape the tissues and optimizes the final outcome. The use of osteosynthesis plates provides stability and reduces the likelihood of prolonged pain or rib shifting during bone healing.
Strenuous physical activity should be avoided for about four to six weeks, although a gradual return to daily activities is usually possible. Regular check-ups ensure proper bone consolidation and symmetrical waist shaping.
Results begin to appear immediately and become more visible as normal postoperative swelling decreases after the first month. Full definition is typically achieved around six months, once the tissues have fully adapted to the new shape.
Results of Rib Remodeling
The change produced by rib remodeling is structural yet harmonious. The waist becomes slimmer, the contour softer and more feminine, and the silhouette more balanced between the upper and lower body.
It is important to remember that each anatomy has its limits, and the aim is not extreme reduction but natural, safe proportions.
At IM GENDER, this technique is integrated into a comprehensive, personalized body feminization plan, carefully evaluating each patient’s anatomy, health, and expectations.
An Option to Feminize the Silhouette
Rib remodeling is an advanced technique designed for trans women who wish to refine their waist and balance the shape of the torso with the hips. When performed by an experienced team, the results are natural, long-lasting, and consistent with the rest of the body.
Each case must be individually assessed to ensure the indication is appropriate and that both aesthetic and emotional benefits outweigh any potential risks.
At the Gender Unit of our clinic, we support every patient throughout the entire process – from the initial evaluation to full recovery – combining medical rigor with human sensitivity.
Would you like to find out whether rib remodeling surgery can help you achieve the silhouette you desire? Contact the IM Gender team and schedule your first personalized consultation.
