I want a flat stomach and snatched waist and I just don't know what to do? (Photo)

hello,
Based on the photos it does seem like you don't need a Tummy Tuck. But only an examination could say for sure. With the question of Lipo, the photos are highly cropped so it is hard to determine because I can not see your entire torso.

However, I have performed Lipo on patients who way less that 128 pounds. I use very thin cannulas (3mm) and extract fat from fine areas. I sometimes use an Ultrasound over the abdomen to determine the amount of fat in the abdomen. In some cases, there really is such little fat to remove that I suggest alternate areas such as the flanks, instead of the abdomen. But generally speaking, in most cases, thin cannulas can do more than fatter cannulas.

Hope this helps and thank you for your question.

Ricardo L Rodriguez MD
Board Certified Plastic Surgeon
Baltimore, Maryland

Hello and thank you for your question. From the pictures you have provided, it is incredibly difficult to assess anything. From the little I can see, it looks like you have a minimal amount of excess subcutaneous fat and skin present mainly in your lower and mid abdomen centrally. I am unable to assess your flanks. Based on all this, and your description, you would possibly benefit more from a traditional abdominoplasty (tummy tuck) to help improve your abdominal/trunk contour.
There is always a possibility you might have a residual vertical scar (from the cutout of your current belly button) if it is determined in the surgery that there is not enough tissue to resect. This may or may not be connected to the main horizontal tummy tuck scar. Of course, we surgeons always try to remove enough skin in the operating room to prevent this vertical scar, if it is safe to do so. Some surgeons pull things tighter than others, but the downside of pulling things too tight and resecting too much skin during this procedure is there can be too much tension on the horizontal wound- meaning they might not be able to get things closed in the operating room, or if they do, the wound will be under too much tension which can significantly increase the risk of wound healing complications (wound breakdown, dehiscence, infection, widened or unattractive scars). Weighing these potential risks against the risk of a small vertical scar which almost always heals uneventfully and is minimally noticeable, I'm sure you'd agree that the small vertical scar is worth it. Regarding the transverse lower abdominal scar, it should be well hidden within your underwear, and if you adhere to proper scar care and sun avoidance after surgery, it (and any potential vertical scar) should eventually heal to be minimally noticeable. And depending on how close the vertical scar is to the horizontal scar, it can always be removed at a later time (6-12 months later) in the office under local, if this is truly a concern.
If your issue is predominantly skin excess, as you mentioned, the less invasive options are not going to be much help (or any help) for your current concerns.
Liposuction is a great adjunct which could possibly provide some additional benefit, particularly to the contour of your flanks (if indicated), and can be done at the same time as your tummy tuck procedure for the best possible single operation results.
With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from these very limited photos and the description provided. It sounds like you have already seen multiple plastic surgeons for evaluation, but you can always seek additional opinions if you want. Ultimately you should choose a surgeon who you trust, feel comfortable with, and who you feel can deliver the best results that align with your individual goals. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Dear weekers,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery