Magallanes-Del RAS, Durán-Vega HC, Castillo-Mejía N, Rivas-Treviño A, Izaguirre-Pérez ME

Language: Spanish
References: 8
Page: 81-85
PDF size: 338.22 Kb.

ABSTRACT

Aesthetic costal remodeling represents one of the most innovative frontiers in body contouring. The RibXcar technique offers a minimally invasive alternative to traditional rib resection, combining ultrasonographic control and bone remodeling without visible incisions. Given its recent development, published evidence remains limited. This systematic review analyzes available studies on RibXcar, with emphasis on surgical safety and complication prevention strategies. A systematic search was made in PubMed, Embase, Scopus, Cochrane Library, LILACS, and Google Scholar from January 2022 to October 2025. All original studies, case series, technical reports and multicenter surveys describing the RibXcar technique or its variations (Rib X Car, Xonversion Ribs + RibXcar) were included. Data extracted included study design, population, technique, ultrasound use, fracture type, adverse events and postoperative management. Seven relevant publications were identified (n = 413 patients): two clinical series (301 and 2203 patients), one international survey (113 surgeons), three technical reports (124) and one combined study with Xonversion Ribs. No major severe complications or mortality were reported; pneumothorax/hemothorax < 2%; severe acute pain 8-10%; superficial burns 0.5%; asymmetries 2%. Ninety-seven percent of surgeons considered the technique "safe" when performed with ultrasound guidance. The RibXcar technique demonstrates a high safety profile when performed by trained surgeons under standardized protocols. Complication prevention depends primarily on ultrasound visualization, patient selection and the learning curve. Prospective multicenter research is required to consolidate long-term safety.

REFERENCES

1. Manzaneda CRM, Duran VH, Cala UL, Viaro M, Adrianzen GA, Botelho DL. Waist remodeling without incision, with ultrasound-guided monocortical fracture. Plast Reconstr Surg Glob Open 2023; 11 (12): e5499.

2. Manzaneda CR. Manzaneda's tool: adaptation of the piezotome for rib remodeling surgery without incisions. Plast Reconstr Surg Glob Open 2024; 12 (5): e5819.

3. Ramírez DR, Ramirez SJ. Waist remodeling without incision, with ultrasound-guided monocortical fracture: report of 220 patients. Plast Reconstr Surg Glob Open 2025; 13 (3): e6595.

4. Manzaneda CRM. Is "clack" enough? rib remodeling guided by ultrasound. Plast Reconstr Surg Glob Open 2024; 12 (5): e5843.

5. Manzaneda CRM, Durán VH, Sieber DA, López Echaury AC, Zepeda TJM. Safety evaluation of the RibXcar technique using the piezotome: an analysis of surgical complications. Plast Reconstr Surg Glob Open 2025; 13 (9): e7130.

6. Manzaneda RM, Adrianzen GA. Waist reduction through conversion from false to floating ribs. Plast Reconstr Surg Glob Open 2024; 12 (6): e5900.

7. Oñate VC, Oñate VD, Hoyos AE et al. Ultrasonic- and ultrasound-assisted improvement of silhouette of the torso: bone structure high-definition remodeling (Part I). Plast Reconstr Surg Glob Open 2024; 12 (1): e5513.

8. Manzaneda CRM, Duran H, Bucio DJJ, Botelho D. Safety in rib surgery: a meta-analysis and systematic review. Plast Reconstr Surg Glob Open 2025; 13: e7442.