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A New Rib Removal Technique For Torso Tapering Or Securing Rib Bone Grafts

Justine S Kim Wendy Chen Elizabeth A Moroni Galen Wachtman Mario G Solari Ernest K Manders
University of Pittsburgh Medical Center
2019-02-13

Presenter: Justine Kim

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. And that this is the original work of the resident.

Director Name: Vu Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction
We present a new technique of 11th and 12th rib harvesting for aesthetic and reconstructive surgical procedures. The rib grafts obtained can be used in reconstructive procedures or the desired result may be thoracic contouring with minimal scars and postoperative pain.

Methods
Sixty-two individual ribs were resected in fourteen patients, for reconstructive or cosmetic purposes. The procedure in each patient can be accomplished in less than 60 minutes. We designed V-shaped dissectors mounted on curved rods, approximating the curve of the ribs. The dissection edges were mounted on each of two mirror image instruments, one for the cephalad side of the rib and one for the caudal side, enabling rib dissection to be performed on both sides through 4-5 cm incisions between the 11th and 12th ribs.

Results
All patients reported an improved thoracic contour and were satisfied with the results. Mean hospital stay was two days and the only complication was mild basilar atelectasis in three patients, which was successfully treated with analgesia and physical therapy. No patients developed a pneumothorax.

Discussion/Conclusions
A novel technique is described for harvesting the 11th and 12th ribs, which can be easily split for reconstructive purposes, such as cranioplasty. The same technique can be used to remove the floating ribs for cosmetic purposes in order to increase vertical waist length in male-to-female transition patients. This method is a good and safe alternative to the current techniques of rib harvesting.

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