Dear Editor,

We would like to draw attention to a controversial topic that has been gaining increasing prominence in plastic surgery congresses: rib remodeling. Interest in the procedure has increased significantly among professionals and the general population, but the available scientific literature on the subject leaves much to be desired.

Currently, most studies on rib remodeling present considerable methodological limitations. There is a lack of comparability regarding the techniques described and a scarcity of studies investigating the actual need for complementation with postoperative corsets, among other techniques so popular in surgery, but with no scientific basis. In addition, most publications do not follow widely-accepted methodological checklists indispensable to conduct high-quality studies, which generate sound scientific evidence. This lack of rigor compromises the validity of the results.

Another worrying point is the quality of the evidence provided by the studies available. Many published articles present before-and-after photographs edited with software such as Photoshop (Adobe Inc., San José, CA, United States), which puts into question the veracity of the outcomes. This practice goes against scientific ethics and generates unrealistic expectations in professionals and patients.

With the increasing popularity of this procedure, it is crucial to perform more robust studies with adequate methodological design, comparison of techniques, and clear criteria for the assessment of outcomes. This is the only way to determine the real effectiveness and safety of rib remodeling in esthetic plastic surgery, which will result in higher safety to perform this procedure in the population.

Sincerely,

Jade Salomé

Julia Munhoz

Maria Pérez

1. School of Medicine, Universidade Anhembi Morumbi, Piracicaba, SP, Brazil

Address for correspondence Julia Leite Munhoz Julia-Munhoz, Faculdade de Medicina, Universidade Anhembi Morumbi, Piracicaba, SP, Brazil (e-mail: juliamunhoz21@gmail.com; 125111346020@ulife.com.br).