Rib Remodelling: The Trend of Breaking Ribs for an Hourglass Waist Carries Fatal Risks

A cosmetic surgical procedure that breaks patients' ribs to create the illusion of an hourglass waist is drawing attention in the medical world. Popularized since 2017, the technique promises permanent changes in body shape, but carries the risk of fatal complications that has led several European plastic surgery associations to refuse to adopt it.

The procedure, called rib remodelling, involves controlled fracturing of the lower ribs, after which patients are required to wear a tight corset for months so the bones fuse in their new position. Originally developed by a plastic surgeon in Russia, the method was later refined in several countries such as Colombia, South Korea, and France. Today, the operation is claimed to be completed in about one hour under general anesthesia as an outpatient procedure.

Behind the aesthetic promise, patients' experiences are far from comfortable. A woman from Miami, Daniela Cesin, said she initially turned down the operation because she was worried about breaking bones around vital organs. But after convincing herself, she underwent a procedure that broke three ribs on each side of her body. Six weeks after surgery, her waist circumference shrank by eight centimeters, but she had to endure an agonizing recovery: difficulty sleeping, pain from the incisions, and acid reflux because of the corset she had to wear 23 hours a day.

Concerns come not only from patients. Sandip Hindocha, a consultant plastic surgeon at Private Clinic, Harley Street, London, expressed skepticism. He referred to a study published in the journal Plastic and Reconstructive Surgery showing a complication rate of 3.7% among 2,351 patients. "That is not a small number," he said, comparing it with breast augmentation surgery, which he said has a lower complication rate. He also questioned the motivation of patients willing to change their bodies permanently, and warned that ribs are a structural part that cannot be restored to how they were.

"If a patient comes to my clinic and says they want to do this, I will ask: why do you want to do it? And why do you want to make a permanent change to your body?" — Sandip Hindocha, consultant plastic surgeon.

The British Association of Aesthetic Plastic Surgeons (BAAPS) also does not support this procedure. Nora Nugent, former president of the association, stressed that the technique is relatively new with limited data on long-term outcomes. According to her, the procedure requires advanced body contouring skills as well as the ability to handle complications that may arise. She estimated that surgeons in the UK may adopt it in the future, but for now it is not available.

Nevertheless, demand for the procedure keeps rising, especially among social media celebrities. Last July, ten Australian influencers flew to Bali to work with a clinic offering rib recontouring. They showed off slim waists on Instagram after surgery, as if the procedure were risk-free. In fact, a transgender patient identified as Sophia had to be rushed to hospital because her lung collapsed by 25% as a result of the operation. She said she was shocked even though she had signed all the consent forms.

Leif Rogers, a surgeon in Pasadena and Beverly Hills, California, predicted that skeletal remodelling will become increasingly popular. According to him, the technique has become much better and social media promotion has made it explode. He even cited the influence of the Kardashian family as one of the triggers for the trend of slim bodies with extreme waists. In the Indonesian context, this phenomenon is not yet mainstream, but it is not impossible that it will spread to major cities as access to information and social media influence increase. Regulation and oversight of aesthetic surgery practices in the country need to be strengthened so that no patient becomes a victim of untested medical experimentation.

The question going forward: will this trend push the emergence of increasingly extreme beauty standards, or instead trigger collective awareness of the dangers of unnecessary body intervention? What is clear is that behind the coveted hourglass waist, there are broken ribs and lurking health risks.