BACKGROUND

Body contouring techniques have limited impact on waist definition because of their focus on soft tissues. Rib remodeling surgeries have emerged as a safer, minimally invasive option to improve the aesthetic definition of the waistline compared with more invasive and aggressive techniques, such as rib resection.

OBJECTIVES

In this study, the authors introduce waistline aesthetic slimming by puncture (WASP) and a parallel approach to enhance the hourglass silhouette and effectively decrease the waist diameter in body contouring procedures.

METHODS

The authors conducted a retrospective cohort study from July 2023 to August 2024, at 3 specialized plastic surgery institutions in Colombia and Brazil. Inclusion criteria were patients undergoing WASP technique. Exclusion criteria included previous rib surgeries, BMI >30 kg/m, chronic respiratory diseases, spinal disorders, and incomplete data. Patients completed a satisfaction questionnaire (Global Aesthetic Improvement Scale) 3 to 6 months postprocedure.

RESULTS

The authors of this study included 125 patients who underwent WASP technique, primarily females (96.8%). Mean age was 34.7 years (standard deviation [SD] 7.1) and mean BMI was 24.1 kg/m (SD 2.4 kg/m). Most patients (63.8%) had no previous aesthetic procedures. Overall complication rate was low at 3.8%, with no serious adverse events reported. Waist measurements improved significantly from a median of 76 cm (interquartile range [IQR] 7.9 cm) preoperatively, 68 cm (IQR 8 cm) postoperatively, and 65 cm (IQR 7.4 cm) 3 months postprocedure, resulting in a waist-to-hip ratio (WHR) decrease from 0.8 to 0.7. Patient satisfaction was high, with 92.9% reporting being "very satisfied" with the outcomes.

CONCLUSIONS

WASP is a safe and reproducible technique, effective for decreasing waist measurements and WHR, overall contributing to the body contouring process.