Rib remodeling as a thoracic feminization strategy in transfeminine patients: Case report

Background: Gender-affirming surgery is a cornerstone of comprehensive care for transgender individuals.In transfeminine patients, the waist-to-hip ratio (WHR) plays a decisive role in the perception of femininity.Rib remodeling has recently been described as an innovative adjunct to thoracic feminization. Case Presentation:We present the case of a 30-year-old transfeminine patient who underwent breast augmentation with 300 cc silicone implants combined with rib remodeling using the RibXcar technique.Preoperatively, the WHR was 0.9 (waist: 77 cm; hips: 84 cm).Controlled fractures of the 10th-12th ribs were performed via small posterior axillary incisions.Results: At four months, CT imaging confirmed rib remodeling with reduced intercostal distances.Waist circumference decreased to 67 cm, yielding a WHR of 0.8.The patient reported high satisfaction, improved body congruence, and no respiratory or functional complications. Conclusion:Rib remodeling appears to be a safe and effective adjunct for thoracic feminization in carefully selected transfeminine patients.