Prospective Evaluation of Anterior Aesthetic Rib Cage Remodeling With Osteosynthesis for Lower Anterior Thoracic Prominence

Inclusion Criteria: * Age 18 to 45 years, or older participants with documented acceptable bone health under the final protocol. * Prominence, dysmorphia, or contour concern involving the anteroinferior rib cage and judged appropriate for ARCO. * Preoperative chest CT, spirometry, medical history, and physical examination completed. * BMI 30 kg/m2 or lower. * Ability to comply with CT, spirometry, BODY-Q, and clinical follow-up through 12 months. * Written informed consent Exclusion Criteria: * Osteoarticular disease affecting rib integrity or clinically relevant osteoporosis risk. * Previous major chest surgery or significant thoracic trauma. * Coagulation disorder, chronic pulmonary disease, or uncontrolled systemic disease. * Active cancer, short life expectancy, or contraindication to elective surgery. * Known adverse reaction to the proposed osteosynthesis material. * Psychiatric condition or body-image disorder that, after specialist assessment when indicated, impairs informed decision-making or realistic expectations. * Pregnancy or breastfeeding.