Costoplasty Questions (also called thoracoplasty)

can you feel the metalwork in your back after scoliosis surgery

What is a costoplasty or thoracoplasty?

I’ve been asked a few times about the costoplasty procedure I had at the time of my scoliosis surgery, so I thought I would try and answer a few common queries about costoplasties below.

When the spine curves it can also twist, this causes rotation of the rib cage which results in a “rib hump,” this mainly occurs with thoracic curves that affect the ribs. In my case I had a large thoracic curve and a very prominent “rib hump” on my right side, caused by the rotation of the spine. Some scoliosis curves can be large with very little rotation and some can be small with lots of rotation, every case is different.

A costoplasty, also called thoracoplasty, is a separate procedure to the spinal fusion, which can reduce the appearance of the “rib hump” that is most often associated with thoracic curves. 

A costoplasty will usually involve the removal of sections of several ribs that protrude – in my case my surgeon removed four sections of rib – ouch!!
The idea is that when the ribs grow back, they will grow back straight, providing you with a flatter back. This procedure can be carried out during the same time as the scoliosis surgery, or sometimes as a separate procedure after the spine has fused. 
Note that you can’t have a costoplasty without first having the spinal fusion to stabalise the spine.

 

Does everyone undergoing scoliosis surgery require a costoplasty?

No. Not everyone with scoliosis will require a costoplasty, it’s generally considered a “cosmetic” procedure. In many cases, especially with the modern instrumentation used nowadays, the surgeon can achieve a fantastic cosmetic outcome without the need for this additional procedure. Also, depending on where the curve is in the spine, the ribs may not be affected and therefore this procedure would not be required. It’s mainly required more for larger, stiffer thoracic curves (like mine). If you have a large rib hump as a result of your scoliosis and are considering spinal fusion, it would be worth discussing the options with your surgeon.

 

Are you pleased with the results?

Yes. Personally, I had a lot of rotation, my rib hump was very large and I hated it. It made me self-conscious and it was painful and uncomfortable to sit against chairs, this is why I decided to ask my surgeon about the costoplasty.

On reflection I am pleased I had this procedure and I would have it again tomorrow if I had to as the results were so fantastic. My rib hump has disappeared and I still can’t get over how flat my back looks even now. I don’t have many pictures of my rib hump side before surgery as I generally tried not to get that side photographed, however the below pictures shows how my rib hump looked before and after surgery:

Rib hump before costoplasty
Rib hump before costoplasty
Rib hump after costoplasty
Rib hump side after costoplasty
Costoplasty Picture - Before and After
Costoplasty – Before and After

Is having a costoplasty painful?

Yes it WAS painful, but that’s not much of a surprise really bearing in mind I had 4 broken ribs!  It hurt to breathe, sneeze, laugh, move!!

I would say the costoplasty pain was worse than the pain from my spine and lasted about 6 months. But for me the pain was all worth it and was controlled well with painkillers 🙂

It’s also worth noting that having a costoplasty adds time onto your recovery period – I had to wear a brace for 3 months to protect the healing ribs – whereas many patients are not required to wear a brace following scoliosis surgery. 

Are there additional risks to having a costoplasty?

Yes, as with any surgical procedure there are risks and complications that can occur with a costoplasty and you should always discuss all the options and risks with your surgeon before making a decision. For example, it lengthens the duration of the surgery and the time that you are under anesthetic.

Hope this helps please feel free to ask any further questions you may have about this procedure and I’ll do my best to help 🙂


Louise x

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What is a costoplasty

20 thoughts on “Costoplasty Questions (also called thoracoplasty)

  1. I'm so upaet my doctor never mentioned this to me. Even after my spinal fusion I'm still so self concious of my rib hump it causes great depression and sadness. I'm 17 and have missed out on all the fun things due to the pain and self consciousness my scoliosis has caused me. I wish I got a costoplasty so much!

  2. Sorry to hear you are upset. I know it's not ideal but you can have a costoplasty as a separate op after spinal fusion once you are recovered. May be worth speaking to your dr or surgeon if it bothers you that much. There are risks as with every other op though so you need to weigh everything up.

  3. Im thinking about doing the operation. But my doctor told me they can only correct the ribs below ur shoulderblade. This made me doubt doing it. I am/was afraid that because of this, the top of my rib hump wouldnt change. But seeing you results makes me really happy. my rib hump right now can quiet good be compared to your rib hump before the surgery. Thanks alot for making this blog.
    I had 1 question, what ribs did they correct in ur case? I assume only below ur shoulderblade. If this is the case then I have a good idea what to expect.

    1. Hi Tommy, thanks for your comment. They cut sections out of four of my ribs, I’m not sure which ones but I think they must have been below the shoulder blade. My right shoulder blade still sticks out because of the residing curve that’s still there pushing it out – they can’t physically move the shoulder blade! But overall I am happy with the results and the rib hump itself in my case is pretty much gone. If you have any other questions let me know, I’m happy to help 🙂
      Louise

  4. Hi Louise, that is great news for me! 🙂
    Thanks for replying so fast.
    And u don’t have any problems with sitting or laying in bed with ur shoulder blade now? And was it painfull the days after the surgery?
    Tommy

    1. Hi Tommy!
      No problem 🙂 I don’t have any problems with sitting or laying in bed now but some chairs can still be uncomfortable as my shoulder blade still sticks out slightly. It depends on the chair though. I tend to sit with a cushion behind me most of the time at home as it’s just more comfortable. It was very painful after the surgery, it hurt to cough, breathe in etc. I was given very strong painkillers though which helped to manage the pain.

      Louise

  5. You’re so lucky. I wish I could do this. I asked my surgeon and he said they stopped doing it years ago because it leads to reduced lung capacity… Currently looking for another hospital that does do it.

    1. Hi Lauren,

      I had my surgery at Oswestry Orthopaedic hospital. I’m not sure which hospitals will do the costoplasty procedure. I think it probably depends on the surgeon and the severity of the scoliosis/rotation. With modern instrumentation and technique, in most cases a costoplasty isn’t necessary as the surgeon can achieve a great result without the need for one.
      Louise x

  6. I am 4 weeks post-op. My surgeon removed sections from 6 of my ribs when he fused my spine to help get rid of the ugly hump. Interestingly, I wasn’t given a back brace. I think a lot of my pain has come from the rib removal rather than the fusion and I still feel really terrible (kind of regret doing this to myself) but aesthetically things are better plus my ribs were used to fuse my spine. Definitely worth talking to surgeons about if you are considering surgery.

  7. Hello Louise,

    Thanks for your blog, just wanna know if you could describe how much of the ribs were cut off? I read one had sections of 6 ribs cut so that makes more than just the ribs under the shoulder blade?

  8. Hi Louise, I’m 36 yrs old. Had spinal fusion done 20yrs ago, I am having costoplasty done in a few months time. How are you getting on now? I really want this done as I’ve spent too many yrs being self conscious of my hump. Bit scared though that I I’m leaving my organs exposed

    1. Hi Laura, good luck for your costoplasty. I’m sure it will all be ok, don’t worry. I’m doing really well now thank you 🙂 I’m sure you will be pleased with the results. Just remember it’s very painful for a while but once recovered you should be fine. Take care, Louise X

    2. Hi Laura, I assuming you’ve had you’re costoplasty op now and just wondering how it went and how are you now? Where did you have it done as I’m thinking about having the same procedure but don’t know of any surgeons that do it! Many thanks!

      1. Hi Debra,
        So sorry for the late reply. I’ve had my surgery cancelled twice now. They need a hdu bed post op just in case and there wasn’t any available on both occasions. I’m due to go back in next week, so fingers crossed. I’m in Ireland, so having it done in Dublin
        Laura

  9. Hi Louise, since you had your surgery, are you able to ride roller coasters or dance.
    What happens to the rib that was cut ?

    Thank you,

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