Flexible cartilage replacement

To replace costal cartilage that has been surgically removed, a surgeon can implant a flexible element to connect a rib to the sternum. In some examples, the flexible element can be formed from a material having a selected durometer (e.g., a measure of material stiffness or hardness), and can be shaped to have a selected geometry (e.g., cross-sectional size and shape), to match the flexibility (e.g. resistance to bending) of the natural costal cartilage. The flexible element can connect to the rib via a rib bracket, which can be rigid, and can attach to a sternal end of the rib via one or more fasteners. The flexible element can connect to the sternum via a sternum bracket, which can also be rigid, and can also attach to the sternum via one or more fasteners. The fasteners can be screws, nails, staples, or others.