In the late '80s, a tabloid suggested that Cher had undergone a risky rib removal surgery to narrow her waistline. The icon, fresh off her Oscar-winning role in Moonstruck, denied the allegation. Two years later, she was said to have hired a British doctor to examine her body and corroborate her truth, but the rumors were never quite put to rest. Even now, in the reporting of this story, several surgeons alluded to the Cher speculation, though not one believes she actually altered her ribs.
I began investigating cosmetic rib surgery after a trusted plastic surgeon informed me that the procedure, long regarded as sheer curiosity or urban legend, has become something more in Beverly Hills. This doctor wasn’t pitching me as a purveyor of the procedure, angling for press. Rather, he presented the idea as a sort of PSA after hearing, secondhand, of a patient in a coma, purportedly due to a complication from a rib reshaping operation. As of yet, Allure has been unable to substantiate the coma claim (our source confirmed with three different people who have knowledge of the matter that a plastic surgeon's rib patient wound up in an ICU in Los Angeles).
What I have been able to verify is that, in select cities across the country, some plastic surgeons are in fact promoting and performing rib removal and, more commonly, rib remodeling (also called rib reshaping, rib repositioning, and rib sculpting) to meet the unwavering demand for hourglass proportions. As research slowly mounts, cosmetic rib surgery is emerging from the shadows as a sort of next frontier in body contouring. Prominent surgeons are lecturing on rib remodeling at aesthetic meetings, inviting peers into their operating rooms to observe their techniques, and teaching courses on the nuances of the waist-whittling procedure.
Still, I wondered, is this merely a fringe phenomenon or are we witnessing its normalization? I DM’d a friend in LA, who does social media marketing for plastic surgeons and always knows what’s up. He suggested that rib remodeling may be on the rise. In fact, he’d just filmed one such operation for a client to share on social. His review: “Even the nurses were looking away.” Well, no wonder: During rib remodeling, the lower pairs of ribs are intentionally fractured before being set at a narrower angle and secured in place with a mandatory corset that encourages the bones to heal in their new configuration over eight to 12 weeks.
The goal here is to carve out curves in an entirely new way. Some surgeons have taken to it, some are adamantly opposed, and some are going with a wait-and-see approach. Board-certified Miami plastic surgeon Adam J. Rubinstein, MD, hasn’t yet adopted rib remodeling (he’s waiting on stronger safety data), but says he understands the growing interest in the procedure. “It does allow us to do something that we just can’t do with other techniques—to give patients a significantly deeper waistline,” he tells me. “No amount of liposuction will change the framework of the body; lipo reveals the body’s innate shape underneath.” A tummy tuck may offer a slight cinching, he adds, by tightening the abdominal muscles and removing excess skin, but again, its effect on the waist is limited by the bones that form the waistline—the lowest ribs and the tops of the hips. If you don’t have much space between the two, then a tummy tuck may flatten your stomach, but it won’t bring in your waist. Ultimately, says Dr. Rubinstein, rib remodeling is “the one method that can change the underlying shape [of the torso] to create a better waistline.”
Faryan Jalalabadi, MD, a board-certified plastic surgeon in Beverly Hills, who doesn’t perform rib surgery or see much demand for it, contends that “it’s extremely rare that a patient needs to rely on rib removal or remodeling in order to get an hourglass waistline.” In his experience, lifestyle modifications and tried-and-true body contouring procedures, like lipo, are usually sufficient. However, he adds, “if the ribs are really close to the hips and you are that rare candidate that could benefit from rib remodeling, you should go to a highly trained expert”—one who has the experience to manage any complications that may arise. Some surgeons deem this operation more dangerous than most in plastic surgery, given the associated risk of pneumothorax, which is a potentially life-threatening event that occurs when air enters the chest cavity, putting pressure on a lung and causing it to collapse. If not immediately recognized and treated, a pneumothorax can lead to a chest tube and hospitalization or, in rare cases, cardiac arrest, coma, even death.
While the vast majority of human bodies aren’t built like Barbie, “a lot of people would like to have smaller waistlines,” Dr. Rubinstein says. Throughout history and across civilizations, Coke-bottle curves, as he calls them, have been considered attractive—a sign of health and fertility. Still, at first blush, the aesthetic almost seems to clash with modern Ozempic culture and its less-than-Rubenesque ideals—until we consider, say, Kim Kardashian at last year’s Met Gala or Demi Moore at this year’s Oscars: The look is lithe and curvy at once—a tiny waist bisecting a corseted bodice and round hips. (I’m not suggesting that these ladies had surgery, mind you. Curves at award shows often come courtesy of couture.)
Off the red carpet, the desired effect of rib remodeling is generally more subdued—“an accentuated figure, not an exaggerated figure,” says David Sieber, MD, a board-certified plastic surgeon in San Francisco. After performing rib remodeling alongside pioneers of the technique in Colombia earlier this year, Dr. Sieber began offering it in his San Francisco practice, where he expects it will hold a niche appeal. (He’s done only a few cases so far.) In Northern California, patients are “more on the conservative side,” he says. “The idea of remodeling the ribs is kind of scary to a lot of them.”
A few hundred miles south, however, patients seem decidedly less daunted. “Over the past few months, we’ve seen a huge uptick in the number of inquiries we’ve received for rib remodeling, whether it’s directly through organic search or via social media,” says Josef Hadeed, MD, a board-certified plastic surgeon in Beverly Hills and the chair of the Patient Safety Committee for the American Society of Plastic Surgeons. He started performing the procedure in 2024 and currently averages seven rib surgeries a month. “A lot of people search for ‘rib removal’ and then, in the course of their research, come across rib remodeling. It immediately piques their interest, because they’re like, ‘Oh, you mean I don’t have to remove my ribs?’ They’re surprised to hear there’s a newer, safer alternative to give them that narrower look to the waistline.” (We’re not talking facelift-level demand here; on average, 3,600 people type “rib removal procedure” into Google each month in the US.)
Echoing Dr. Hadeed’s sentiment, a systematic review of studies on rib removal and rib remodeling for body contouring, published in 2025 in Aesthetic Plastic Surgery (the journal of the International Society of Aesthetic Plastic Surgery), asserts that “rib remodeling appears to offer a less invasive alternative to full-rib resection, with a reduced risk of complications.” However, the authors state, “the current literature is insufficient to provide conclusive evidence regarding the long-term safety and efficacy of these procedures.” And that makes some surgeons very wary.
The rise of rib remodeling
Despite technical differences between the two operations, rib remodeling is commonly compared to rib removal, because the former is essentially an evolution of the latter. Over time, “we’ve innovated safer techniques,” says Dr. Hadeed.
Historically, rib removal has been performed mainly by thoracic surgeons (who specialize in the chest) to treat fractures, infections, tumors, and other serious medical conditions. The earliest reports of rib removal in the plastic surgery literature date back decades and involve primarily transgender patients wanting to reshape “boxy” torsos. (“This one move massively feminizes the entire trunk contour,” says Sergey Turin, MD, a board-certified plastic surgeon in Scottsdale, Arizona, who started doing rib remodeling surgeries in December 2024.) But there’s very little on rib modification surgeries in aesthetic journals before 2020. It’s just over the last five years that there’s been a smattering of studies aiming to legitimize the procedures.
The highlights include a case series out of Mexico describing the removal of the lowest two ribs on each side as a “not-gory technique with a low complication rate.” The author treated 104 women over eight years; two suffered a pneumothorax (collapsed lung) during surgery. Another frequently cited paper, from two Russian physicians, introduces a “minimally invasive surgical method of waist shaping with rib preservation,” whereby surgeons access the lower ribs through short incisions in the back and fracture them before resetting the bones and splinting them with a corset. Advancing the procedure, South American plastic surgeons have published various methods to further shrink incisions (to mere punctures) and boost the safety of the operation by incorporating ultrasound (so surgeons can clearly see the anatomy) and refining the tools they use to crack the ribs.
Rib removal as a method for reducing the waistline has always been regarded as a rare and radical procedure (it’s not one that aesthetic societies even bother to track). Beyond the potential complications and drawbacks of rib removal—infection, obvious scarring, chronic pain, lung injuries, pneumothorax, breathing issues—the procedure entails a long recovery and “often gives a very dramatic, unnatural-looking result,” Dr. Hadeed says. (To his point, in some parts of the world, aesthetic rib removal is literally known as “ant waist surgery”—a nod to the bug’s minuscule midsection.) And let’s not forget, he adds, “removing ribs also removes some of the protection that the rib cage is meant to provide for internal organs.”
Rib removal can also have respiratory ramifications. The aforementioned Aesthetic Plastic Surgery review acknowledges that “changes in the rib structure may affect the mechanics of breathing, potentially leading to difficulties with deep breathing or reduced lung capacity, particularly in the immediate postoperative period.” In a study from 2024—claiming to be the first to investigate how aesthetic rib removal affects the lungs—researchers ran pulmonary function tests (which measure how well the lungs are working) on 11 Jordanian women who had their lower two pairs of ribs taken out. They then compared the results to those of a control group—11 women of similar age who did not have surgery—and determined that rib removal “had a significant adverse effect on lung function and respiratory muscle strength.” (They did not, however, test the lungs of the surgical patients pre-op to see how the procedure impacted each subject directly.) A 2024 retrospective review in the Journal of Thoracic Disease looking at changes in lung function after rib removal (in patients with cancers or infections of the chest wall) found that “there was a significant long-term decrease in pulmonary function” after surgery in cases where three or more ribs were removed.
Still in its infancy, rib remodeling was “designed to be minimally invasive and far safer than rib removal surgery,” says Dr. Hadeed, “offering an effective option for people who want to fine-tune their natural shape and aren’t looking for a drastic alteration in their waistline.”
Jennifer, 37, a business owner in San Diego, had rib remodeling surgery with Dr. Hadeed in November 2024. “I went from a 28-inch waist to a size 25 waist and feel so much happier with my body,” she says. Numi, 33, who’s about four months out from rib remodeling with Dr. Turin, says her body has taken various shapes over the years, but whether she was skinny or heavier or more muscular, “my silhouette remained straight,” she says. Rib remodeling shaved five inches off her waistline. “I feel more feminine and genuinely more aligned with how I’ve always envisioned myself,” she says. “Clothes fit better—they compliment my shape more naturally—and I no longer feel the need to ‘create’ curves with styling tricks.”
Knowing that rib remodeling is “still a relatively new procedure,” Numi did her due diligence before committing. “There aren’t many firsthand patient experiences out there, but I did as much research as I could, reading through medical explanations from multiple surgeons, watching videos where doctors detail their methods, and digging through Reddit threads where a few patients shared their journeys,” she says. Ultimately, she felt confident in the safety of the operation. “Choosing a qualified doctor made all the difference,” she says.
While the procedure “is entering a heyday and many more [doctors] are performing it, there is real risk,” notes Daniel J. Gould, MD, a board-certified plastic surgeon in Beverly Hills. He tells me that there’s a surgeon who does rib remodeling at one of the ORs he works in, and the anesthesia team refuses to staff those cases due to safety concerns. “It may become safer with time, but I can’t imagine doing that surgery just to make the waist a little bit smaller. I looked into it three years ago when Colombian surgeons started offering it as the ‘Barbie waist.’ I feel like it’s hard to offer it, even if it is safe, because ultimately it feeds into the alienization of bodies.” (In aesthetics, alienization refers to the distortion of the face or body in ways that are uncanny or beyond the realm of normal anatomy.) At the same time, Dr. Gould is quick to acknowledge the elective nature of cosmetic surgery: “I don’t want to appear hypocritical—we all do surgeries that no one needs.” And while one procedure may be more socially acceptable than another, none is without risk.
Based on an unofficial review of the literature (a skimming of studies I sent his way), Steven Teitelbaum, MD, a board-certified plastic surgeon in Santa Monica, also has reservations about rib remodeling—regarding both the aesthetic it can create and its uncertain safety profile. “I believe people should have the freedom to choose the body they want, but I think plastic surgeons should only allow that to be within the realm of what a human body can actually look like,” he says. To his eye, the results of rib removal and remodeling can sometimes make patients look “exceedingly cartoonish” or even “like insects,” he says, particularly when the indentation is “too severe and abrupt” or falls in the wrong place, “narrowing people above where the narrowest part of the waist should be.”
Who’s a candidate for rib remodeling?
According to my sources, patients seeking cosmetic rib surgery are typically athletic women with square or straight torsos, who want to adjust their waist-to-hip ratio, but lack the fat needed for more mainstream contouring procedures, like liposuction and fat grafting. “If there’s not a lot of fat [in the midriff] to be removed, then I can’t do lipo to carve a waist or redistribute that fat to the hips,” says Dr. Turin. “If someone is very lean and wants an hourglass figure, rib remodeling is pretty much the only operation that’s going to produce that for them.” Dr. Turin says that over the past few months he’s performed about seven rib remodeling procedures. Looking ahead, he has one scheduled every two to three weeks through the summer—all word-of-mouth referrals, he says.
The surgeons I spoke to all agree that more conventional body-contouring options—like lipo and tummy tuck—should be ruled out before considering rib remodeling. “It’s not right for everyone,” Dr. Sieber says of the controversial procedure. “I think it’s good for people who tend to be really boxy—meaning their rib rage almost connects with their hip bone,” preventing them from achieving a deep waistline by other means. Again, what allows for that enviable dip is the combination of short hips and a high rib cage, which puts ample space between the two bones. In reality, Dr. Sieber says, “when we remodel the ribs, what we’re aiming to do is increase the distance between the top of your hip and your lowest visible rib.”
But without physically removing ribs, how exactly is this possible? I had a hard time wrapping my brain around it at first, but here’s the deal: When the lower ribs are manipulated, “they swing in and out of the way, so there’s a significant visual increase in the distance [between ribs and hips],” Dr. Turin says. Suddenly, what we perceive as the high point of the waist is a middle rib rather than the lower ribs. To be clear, “rib remodeling does not alter the vertical positioning of the ribs,” Dr. Hadeed adds. The ribs are not shifting up or clearing out. “The procedure adjusts the angle of the ribs to create a more contoured waistline, but the distance between the lower ribs and the top of the hip bone remains unchanged.” In a trick of the eye, “the reshaped waist creates the illusion of increased space between the ribs and hips.”
Amelia, 29, a content creator in Las Vegas (who has posted about plastic surgery on her Instagram page, @amyfabooboo), is less than one month out from her rib remodeling procedure with Dr. Turin, and says she’s happy with her new waist-to-hip ratio. “Because I’m constantly in front of a camera, having a smaller waist has significantly boosted my confidence,” she says. “I wanted to achieve a dramatic hourglass silhouette without having to be edited, and now, I don’t think I’ll ever again feel like I have to edit my waist in pictures or videos.”
Beyond possessing the right physical traits (less than an inch or two between ribs and hips, plus minimal fat), candidates for rib remodeling should be healthy and have bones strong enough to withstand the controlled fracture and to mend properly. (Some surgeons won’t perform the procedure on patients over 45 or 50, because they worry about poor bone density and impaired healing.) Reasonable expectations are another prerequisite for rib remodeling, according to the experts I interviewed. Aspirations can’t be extreme, since the procedure is powered to deliver only “a little bit of curvature,” says Dr. Hadeed, “realistically, a two- to four-inch reduction in the waistline.”
What happens during rib remodeling surgery?
The ribs that are typically targeted in aesthetic rib surgery are the lowest two or three on each side. Doctors call the last two pairs “floating ribs,” because unlike most of the upper ribs, which connect in our back to the spine and in our chest to the sternum, the lowest ribs (numbers 11 and 12, technically) are unattached in the front, making them easier to manipulate. Some surgeons also treat the rib right above (number 10), “even though it’s connected in the front by cartilage,” says Dr. Turin. Doing so can give a “smoother transition between the chest, the waist, and the hips,” he says, for a less angular look overall.
The surgeons I interviewed say that imaging is a critical part of rib remodeling. Before operating, they order a CT scan with a three-dimensional reconstruction of the rib cage to review the anatomy and check for abnormalities—severe asymmetries, scoliosis, unusual spacing between ribs, missing or extra ribs—that could affect their surgical plan. Additionally, doctors use ultrasound throughout the procedure to pinpoint the ribs they’re going after, to confirm fractures were made correctly, and to assess the condition of the lungs. “I don’t think you can safely do the procedure without ultrasound,” adds Dr. Turin.
During rib remodeling (which can be done under general anesthesia or IV sedation), surgeons make small openings in the skin of the back to access the ribs. The exact size of the incisions depends on the type of tool they use to fracture the bones. Some rely on an ultrasonic device called a piezotome, which has a tiny vibrating tip that can slowly cut through bone without harming surrounding tissues (this makes it a go-to in rhinoplasty, as well). Inserting the piezotome requires only large needle pokes in the skin. Other surgeons prefer to fracture the ribs using a specialized hand saw, which demands slightly wider entry points: “I make two separate incisions on the lower back, one on each side,” says Dr. Hadeed. “Each is about one centimeter long and placed in the natural crease lines of the back.”
As an added precaution, anesthesiologists may “exhale the lungs” just before surgeons address the ribs, says Dr. Hadeed, to move up the diaphragm, in hopes of “eliminating the risk of injuring the lungs while the ribs are repositioned.” (The diaphragm is the main muscle involved in breathing; it sits below the lungs, at the base of the chest cavity. Puncturing it or the lungs could cause a pneumothorax.)
Surgeons make partial cuts through the ribs resulting in “incomplete fractures.” Dr. Turin likens the process to snapping a branch on a young tree that’s still very supple and green. “When you break it, it kind of loses its rigidity, but the broken piece doesn’t fall off—it’s still connected, but it’s mobile,” he explains. Ribs being reshaped meet a similar fate. Once incisions are closed and patients wake up, surgeons outfit them in a corset, instructing them to wear it 24/7 (save for showering) for about three months. “When they take it off, the fractures are going to be healed in their new position and the patient will have a tighter waist,” Dr. Turin says.
What’s the recovery like?
The steel-boned corset is an integral part of the recovery process. “I tell all of my patients, ‘I do about 40% of the work and you do about 60%’—because no matter how good of a job I do in surgery, if they’re not compliant with the post-operative protocol, they’re not going to get a good result. And a huge part of that is wearing the corset,” says Dr. Hadeed. “Deviating from the protocol increases the risk of the ribs shifting back to their original position or healing asymmetrically.”
The corset not only stabilizes the ribs to aid healing, it lessens discomfort. Says Dr. Turin, “Having the corset as tight as possible is going to keep pain at a minimum.” Even so, adds Dr. Sieber, “most people are pretty uncomfortable for seven to 14 days, especially when stretching, taking deep breaths, coughing, and sneezing.” Doctors routinely prescribe pain relievers and anti-inflammatories to ease the early recovery.
“It really felt like a full lifestyle adjustment—how I moved, ate, dressed, and slept had to shift to accommodate the healing process,” says Numi. “It’s definitely uncomfortable and I highly recommend having someone around to help during the first few weeks, because it’s so important that the corset is positioned correctly. If it’s even slightly off, it can cause extra discomfort and affect how your ribs heal and set.” Finding a quality corset that fits precisely can take some trial and error. “I went through at least four different brands and styles trying to find the right one,” she says. “The corset is a functional tool that acts like a cast for your ribs, so it’s absolutely critical. Looking back, I truly believe that having had the right corset from the start could have made a big difference for me, not only in minimizing discomfort, but potentially giving me an even more refined result.” Surgeons provide corsets at the outset, but since "different styles are better suited to different builds," says Dr. Hadeed, patients often experiment with multiple corsets throughout their recovery.
Patients with desk jobs are usually back to work within a week or two, but have to abstain from exercise until cleared by their surgeon. For some, that means no working out until the fractures fully heal and the corset comes off, two to three months after surgery. In other cases, surgeons may allow patients to resume light cardio at six weeks and everything else–weight training, yoga, sports—at three months.
Bottom line: Is rib remodeling safe?
In surgery, certain risks are universal—infection, hematoma and seroma (collections of blood or fluid under the skin), swelling, bruising, pain, and poor healing, to name a few. But with rib remodeling, “pneumothorax is the big, bad thing that we think about,” says Dr. Turin. “Going too deep and damaging the lung or the covering of the lung—it’s really rare, but still hypothetically possible,” which is why surgeons use ultrasound to ensure they’re working at the appropriate level. While safety protocols and meticulous technique may lessen the likelihood of creating a pneumothorax, adds Dr. Teitelbaum, “the risk of it will probably never be eliminated.” That said, “good monitoring after surgery should be able to catch a pneumothorax early and if treatment is initiated early there shouldn’t be a bad outcome.” To treat a collapsed lung, Dr. Sieber explains, “you evacuate the air with a needle or chest tube to fully re-expand the lung, and then check it with a chest X-ray.”
Other remote dangers of rib surgery include injury to the nerves that run underneath the ribs as well as damage to the kidneys, which sit deep behind the floating ribs. Cosmetic risks include asymmetry, visible scars, and ribs that revert back to their original position (mainly from improper corset use, experts say). In rare cases, “you can get something called a nonunion, where the bones, for one reason or another, don’t quite heal,” Dr. Sieber says, “so they never re-ossify and they’re kind of just floating sections next to each other.”
Critics of the procedure worry about the surgery’s 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 “intentionally shrinks the lower portion of the chest wall, you’re impinging on the space that the lungs are meant to have,” Dr. Rubinstein explains. “The tighter you make it when attempting to pull in the waistline, the less space the lungs have for taking deep breaths.”
Dr. Turin likens the effect to inhaling deeply while wearing a corset or Spanx. “It can be done, but it’s a bit harder than breathing unrestricted,” he says. After surgery, he posits, a patient’s pulmonary function tests could look a little different, but in his opinion, that slight change would be “relatively immaterial to the majority of the population.” Dr. Hadeed adds that “the lungs typically only extend down to about the 10th rib,” and it’s generally the 11th and 12th ribs that are repositioned.
Dr. Teitelbaum argues that even a small loss of pulmonary function may, in fact, be meaningful—“dismissing it would be like saying a small heart attack is irrelevant for most people”—and 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’ lungs fare. “These things need to be known,” he says. Presently, however, such testing isn’t standard practice. None of the surgeons I spoke to who perform rib remodeling do these before-and-after pulmonary tests, maintaining that they’re unwarranted.
Overall, data is lacking. “Rib remodeling hasn’t 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,” says Dr. Rubinstein. I did find one study from 2024 detailing a remodeling treatment for “winged ribs” (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 “much closer proximity to the lungs” than they are during traditional rib remodeling,” Dr. Hadeed says.)
While Dr. Rubinstein has concerns about rib remodeling, he doesn't dismiss the procedure out of hand. “I think there’s a role for almost everything in the right circumstances—if 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,” he says. Looking ahead, he adds, “there may come a time in the not-so-distant future when this is just another procedure that we do.” The BBL seemed exotic 20 years ago, he reminds me, but today it’s performed routinely in ORs across the country.
Dr. Teitelbaum thinks the emergence of rib remodeling raises “an interesting moral question—should plastic surgeons do whatever a patient wants, however ludicrous? Is this any different than giant breast implants or overinflated lips?”
But then there’s this question: Who defines “ludicrous”?
For now, says Dr. Rubinstein, “I’m 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’s a long run for a short slide.”
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