Just because you could do something doesn’t mean you should. I recently had a patient who brought in photos of what she wanted her tummy tuck results to be, and it was an exaggerated hourglass profile I don’t think is achievable for her. In the October NY Times, they had an article on “Plastic Surgery Comes for the Waist.” You see terms discussed a lot- “Removal rib,” “Remodeling Rib,” “Waist narrowing,” “Waist-hip ratio.”
So what is the newfound focus on the waist?
What is the buzz about waist reductions?
Waist reductions are not new. People in the past have removed ribs to give a starker transition, to make the waistline smaller. It is not a common operation. But with technology and advancements, there is a newer less invasive technique out. The newest iteration of this has a couple catchy names.
- WASP technique, which stands for “Waist Aesthetic Slimming by Puncture.” In this technique, there are small incisions made and a greenstick fracture is made of the rib. For the following 3 months a corset is worn, causing the recently broken bone to heal at a different, narrower angle.
- Barbie waist is another term for the same procedure. “It is a more friendly name for the public.”
What are the negatives of doing a waist reduction?
This is not well studied. You can imagine though the issues with waist reduction are similar to what we see in people who wear “waist trainers” to try to mold their ribs over time due to pressure.
- Breathing issues. You are restricting diaphragm and lung movement which reduces lung capacity. Studies on trainers estimate it to impair lung capacity by 30-60%. Shallow breathing reduces oxygen levels, which can lead to dizziness, fatigue or fainting, particularly when exercising.
- Heart issues. Constriction may lead to circulation issues which can stress the heart.
- Internal Organ Compression can occur, which can impair blood flow and hurt organ function.
- Digestive issues happen due to pressure. It can affect digestion and acid reflux. You may feel discomfort after meals.
I would add to this list that the ribcage is there to protect vital underlying organs. Hurting this protective cage may make your organs more susceptible to damage. Also as you age, how do your bones heal? Are you osteopenic? If you make a break in the bone, how strong is it after the break? Is there pain? What if it doesn’t heal?
The one published retrospective review of Waist “Improvement” Surgeries concluded, “Complications included pain, pneumothorax and wound dehiscence. Follow-up periods ranged from 3 to 6 months. While rib resection and remodeling appear to be safe techniques, their long-term efficacy remains uncertain. Studies with rigorous designs and longer follow-up are needed to establish robust evidence.”
Is there another way of making the waist smaller?
Yes! And these are well established, safe, and improve abdominal function or body health.
- Liposuction. Have love handles? A little belly pooch? Liposuction is a great tool to help reshape the body and sculpt.
- Abdominoplasty. This surgery involves three ways to improve your waistline. First, I fix your diastasis- the muscle separation that occurs with pregnancy or major weight loss. This not only makes your waist smaller, it is improving your core strength with significant improvements seen in lower back pain and urinary incontinence. Second we are tightening the skin, smoothing the skin to remove overhangs or folds. Third, I incorporate liposuction of the flanks as part of all of my tummy tucks. I have had patients go down 6 inches in waistline from this procedure. I love the functional benefits as well. It is a great surgery
- Losing weight. For many, the thickness in the waistline may be due to weight gain, particularly intraabdominal or “visceral” fat. This fat cannot be liposuctioned. The only way to lose this fat is to lose weight. Diet, exercise, intermittent fasting, and GLPs can all assist in this. Visceral fat is associated with metabolic syndrome- diabetes, heart disease, stroke. Improving this has loads of other health benefits.
- Exercise. It is so important to build muscle as you age. I am a big believer in creatine (we carry German micronized creatine in our office) and resistance and weight training. Muscle is also important for posture, diabetes control, bone health, and dementia prevention.
Dr. Greenberg’s thoughts on waist reductions
Media and Medical Citations
Costal Surgery for Waist Improvement Safety and Efficacy: A Systematic Review of the Literature, AEsthetic Plastic Surgery Journal, June 2025.
NY Times article Plastic Surgery Comes for the Waist., October 12, 2025
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
