{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:51:03Z","timestamp":1791924663110,"version":"4.3.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Traditionally, aesthetic waist treatment has focused on soft tissue modification; however, the underlying osteocartilaginous framework may constrain outcomes. The concept of the waist as a three-dimensional structure, defined by transverse width, craniocaudal length and anterior projection, has facilitated the development of targeted osseous remodelling techniques.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To describe and evaluate a comprehensive therapeutic framework based on a three-dimensional algorithm for the aesthetic treatment of the osteocartilaginous waist, with a 12-month clinical follow-up.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A multicentre, prospective cohort study was conducted between April 2024 and January 2025 across four countries. Three hundred and eighty-four patients with a minimum of 12-month follow-up underwent osteocartilaginous procedures (RibXcar, FrontXribs and Xcrest), either individually or in combination, according to a standardized algorithm based on thoracic width, waist length and anterior projection. The outcomes included waist circumference, rib angulation, thoracic diameter, iliac crest distances, respiratory function, postoperative pain, complications, and BODY-Q satisfaction scores.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Baseline characteristics were comparable across all groups. All procedures achieved their expected outcomes, demonstrating sustained improvements at 12 months. Respiratory function remained stable throughout the follow-up period. Postoperative pain resolved without sequelae and there was a significant improvement in BODY-Q scores across all domains.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A three-dimensional, algorithm-based approach enables the rational and reproducible treatment of the waist, achieving consistent structural modification through targeted interventions while preserving respiratory function and ensuring high patient satisfaction. This model establishes the waist as a true three-dimensional anatomical unit in body contouring surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/asj\/sjag225","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:47:05Z","timestamp":1791632825000},"source":"Crossref","is-referenced-by-count":0,"title":["The Waist as a 3-dimensional Structure: Clinical Evaluation of an Algorithm-guided Osteocartilaginous Treatment in a 12-month Follow-up Cohort"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1359-2298","authenticated-orcid":false,"given":"Ra\u00fal M","family":"Manzaneda Cipriani","sequence":"first","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3399-6302","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Duran","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Merida Yucat\u00e1n , M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo A","family":"Adrianzen","sequence":"additional","affiliation":[{"name":"Physicians in private practice in Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Flores","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Ciudad de M\u00e9xico , M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose David","family":"Salazar","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Medellin ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres Ervind","family":"Mendoza Arteaga","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon, Faculty of Medicine, National University of San Marcos , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margiory","family":"Fernandez Rodriguez","sequence":"additional","affiliation":[{"name":"Physicians in private practice in Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,13]]},"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjag225\/71915109\/sjag225.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjag225\/71915109\/sjag225.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:29:32Z","timestamp":1791923372000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/advance-article\/doi\/10.1093\/asj\/sjag225\/8914577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/asj\/sjag225","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"article-number":"sjag225"}}