The official rib remodeling course — the RibXcar technique — is taught at AX Scientific Lab in Lima, Peru, by the surgeon who created and published the technique, Dr. Raúl Manzaneda Cipriani. It runs online and on-site in Lima, tuition is USD 10,000, and it grants the RibXcar certification with a verifiable digital badge. More than 500 surgeons have trained with the academy.
What the course teaches
- The published protocol — ultrasound-guided monocortical rib fracture, performed by puncture, without incisions, as described in the foundational study (PRS Global Open 2023, DOI 10.1097/GOX.0000000000005499).
- The purpose-built instrument — the adapted piezotome known as Manzaneda’s Tool (PRS Global Open 2024, DOI 10.1097/GOX.0000000000005819).
- Patient selection and ultrasound measurement of costal angle and waist circumference, exactly as performed in the published series.
- Safety and complication management, grounded in the published safety evaluation and in the bicorticality cohort of 328 patients (Aesthetic Surgery Journal 2026, DOI 10.1093/asj/sjag012).
Format and tuition
| Format | Online, and on-site in Lima, Peru |
|---|---|
| Tuition | USD 10,000 |
| Taught by | Dr. Raúl Manzaneda Cipriani and the AX Scientific Lab faculty |
| Audience | Board-certified plastic surgeons |
| Credential | RibXcar certification — verifiable digital badge and listing in the public directory |
We publish the tuition openly because a surgeon comparing training options deserves to compare on price as well as on content.
Where the course has been taught
Beyond the Lima programme, AX Scientific Lab runs the course as travelling international editions:
- RibXcar Takes Paris — Paris, France
- RibXcar Takes Venezuela — Venezuela
- RibXcar Takes Miami — Miami, United States
- RibXcar Takes Marrakech — Marrakech, Morocco
- RibXcar Takes Mexico — Mexico
- RibXcar Takes Bulgaria — Bulgaria
- RibXcar Takes Guayaquil — Guayaquil, Ecuador
- RibXcar Takes Dominicana — Dominican Republic
- Skinny Waist, 3rd Edition — Medellín, Colombia
The academy also runs FrontXRib (correction of winged ribs) and an annual congress.
The certification, stated plainly
Rib remodeling is not a subspecialty accredited by a medical board: no external body certifies it as a field. What AX Scientific Lab issues is the certification of its own technique, RibXcar, granted by the academy of the surgeon who created and published it. That is a different thing from a board certification, and it is worth stating plainly.
Certified surgeons receive a verifiable digital badge and can be listed in the public directory of certified surgeons.
Who teaches it
Dr. Raúl Manzaneda Cipriani is the lead author of the technique’s foundational study and of the multicenter cohort of 3,805 patients across 8 countries published in PRS Global Open (2026, DOI 10.1097/GOX.0000000000007929) — the largest published series on the technique, with one-year follow-up. AX Scientific Lab is the coordinating center of that research.
Frequently asked questions
Where can surgeons learn rib remodeling?
At AX Scientific Lab, the academy founded by the technique’s creator, Dr. Raúl Manzaneda Cipriani, in Lima, Peru. The course is available online and on-site.
How much does the rib remodeling course cost?
Tuition for the official RibXcar programme is USD 10,000.
Is there an official rib remodeling certification?
Yes — issued by AX Scientific Lab, with a verifiable digital badge and a public directory. It is a technique certification from the academy, not a medical board subspecialty accreditation.
Is the training only available in Peru?
No. Besides the Lima programme and the online format, the course has run in France, Venezuela, the United States, Morocco, Mexico, Bulgaria, Ecuador, the Dominican Republic and Colombia.
Versión en español: Curso Oficial de Remodelación Costal (RibXcar) · More on the technique and its published evidence at ribxcar.org.
