This is a tough question, I'm assuming an expert surgeon doing the surgery..

I think depending on the severity of all symptoms, some surgeons may remove both of those ribs and /or snip some scalenes also.
Most prefer many tests before doing surgery. Unless clots are an active issue.


The main difference that I have read, is if only the extra c ribs are the issue, then a very good outlook for post op & long term recovery.

Logically those aren't supposed to be there so removal is a good thing..less crowding and more room for needed structures.