In case you couldn't tell, I have issues with Patch. It's one of those 'high level' tools and you can't always tell what it's going to do. When using it for large, gross fixes, it can do some really weird things. For that reason, I prefer to use it at the 'lower levels'. I've heard that the Patch tool in PS CS can be extremely weird at times. Causing bizarre rainbows and things.
Fine for the little fixes, but not the big ones.
Make sense?
(Of course, personal preference. If your Patch-style Kung Fu is good, go for it.)
Back to fixing the ribs. In particular, the hue and sat after messing around with luminosity. Lot's of different ways, but let's do something that is rather simple and straight-forward.
New layer above all of it.
Set blending mode to Colour.
Paint away.
I usually use Paintbrush with opacity around 50% or so for this kind of painting.
Also, use alt + click to sample colours from 'good' flesh.
Also, not a bad idea to have Colour palette open and set to HSB.
Colour mode is Hue & Sat (how convenient), so you only really need to pay attention to those two.
For this in particular, I like Hue around 3 and Sat around 25.
Caveat
In general, you can usually be really sloppy with hue and satuartion. However, the human brain doesn't always see things the way a computer sees the data. Sometimes a tiny little shift in sat can cause the brain to see a significant shift in hue. A classic example of this is veins. The brain will see veins as a shade of blue, but the computer will see red with low sat.
Just something to watch out for.
In the end, I'm a big fan of tearing apart and fixing the little things.
Tore the photo apart into colour (hue and sat), and luminosity.
Even tore the luminosity apart into high and low frequencies.
Didn't tear it apart as deep as I usually go, though, but tore it apart enough.
I love it.