Abstract
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(2), 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(2) (SD 2.4 kg/m(2)). 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.