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Best Option for Stubborn Belly and Flanks Fat on Healthy 40 Year Old?

asked 2 years ago by humm in MIami
Latest answer by Tom J. Pousti, MD
Question viewed 2,681 times
Tags: age 35-44, flanks, female, 5 ft 4 in to 5 ft 7 in, belly, fat, fat reduction, loose, skin, thin

I have stubborn fat in belly and flanks, the right side has more “deposits”. I am almost 40 have healthy eating habits and exercise on and off most of my life. With 1 child. I am 5'7" and pretty thin. I've had 3 consults.

First surgeon told me to get a Tummy tuck because of loose skin on top of the belly button with Liposuction. The second said he couldn’t even do Liposuction and a Tummy tuck was preposterous.

Third suggested combo of lipomax, Carboxytherapy and Mesotherapy but after reading on these, I don’t like mesotherapy and there's not enough information on future side effects of carboxytherapy. It doesn’t seem unhealthy but I really question results.Thanks!

22 answers to Best Option for Stubborn Belly and Flanks Fat on Healthy 40 Year Old?

Tummy tuck vs. liposuction

Dr. Rand is right that you are doing very well overall. However, there is slight looseness of skin and some fat in the abdominal area, plus you have probably noticed that your waist is wider since you had your child. It may be possible to have a full fascial tightening with a small excision of skin from the lower abdomen, conservative liposuction, and slight umbilicoplasty to give you your best result. That way you could avoid the hip to hip incision while still tightening the deep fascia... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Are you really seriously unhappy with your abdomen?

Given that 98% of the world's 40 year-old women would trade abdomens with you straight up, I wonder how much perfection you need to be happy?? You should do nothing - any surgery involves cost and potential risks for VERY LITTLE gain. I can only hope as you continue on into middle age you can be less severe with yourself and love how lucky you are to have been gifted genetically with the great body you have!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

You look pretty good after kids

Sounds like you should do nothing -- I don't know what the two weird therapies are -- stay away. Wear one piece bathing suits not bikinis if your tummy really bothers you.

William B. Rosenblatt, MD
New York Plastic Surgeon

No solution is often the best solution

I talk to my patients about the choice of being content versus the choice of being discontent. Sometimes a problem has no ideal solution. Yours might be this situation where something that bothers you cannot be improved upon very easily and you should try to accept being content rather being discontent.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Stubborn “Belly Fat”

Thank you for the question and picture. You may not like my advice but there is a saying in plastic surgery that the “enemy of good is better”; in other words, you should be careful not to do any harm to what looks like a pretty good abdomen. There are a lot of gimmicky therapies marketed aggressively which you should avoid at all costs. These will prove to be a waste of time and money for worse cause deleterious changes. Again, it may... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Liposuction vs. Tummy Tuck for abdominal skin

Without examining you, it is difficult to asses your skin tone. Based on your photo liposuction may be a good option if your skin tone is normal. Mesotherapy and the other procedures recommended to you have not stood the test of time and most likely will fall to the way-side. Remember Endermologie?! Liposuction and tummy tuck are reliable and time-proven procedures. If a patient is borderline between the two, it is always better to do the less invasive with less scar procedure first and... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Tummy tuck versus liposuction

Based on the pictures, I think you would get the best results from tummy tuck. You are not going to get much skin tightening with liposuction. You look like you are otherwise in shape and should do well with surgery. see video

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Ultrasonic or Laser Lipo will remove fat and likely offer some skin tightening

Based on your photos, I think that liposuction that uses energy to dissolve the fat (Vaser ultrasonic, Slimlipo laser, etc) will give you the best result. These techniques remove fat as smoothly as possible and provide some tightening for the skin to help minimize the risk of postoperative skin irregularities. Seek out a plastic surgeon experienced in body contouring as his or her physical exam will allow the most accurate assessment of how much fat is present and how much skin laxity is... more

Michael D. Yates, MD
Huntsville Plastic Surgeon

Abdomen questions

First, I would absolutely avoid mesotherapy. There is no scientifc proof that it works at all. IN fact, it may cause problems. As to the question of tummy tuck, liposuction of both or none, it would be very difficult to tell without examining you. Just from the single photo, it looks like you have good tone. Hard to tell if you have significant fat to lipo, or excess skin to remove.

Steven Wallach, MD
Manhattan Plastic Surgeon

Tummy tuck vs liposuction

The reason you are getting so many different answers is because you fall in that questionable category. In my opinion you do not have enought fat for liposuction and doing any kind of liposuction that claims you will have enought skin tightening is far from the truth. A tummy tuck will remove the loose skin you have and may be an option for you but difficult to say without really rexamining you and seeing your abdomen as a whole and how high your belly button is from the pubis area. So... more

Farbod Esmailian, MD
Orange County Plastic Surgeon

Superficial liposuction can actually tighten skin.

Hi. You look pretty good! I agree that tummy tuck is preposterous. Conservative superficial liposuction with sub dermal tunnelling is all I would recommend based on your picture.

George J. Beraka, MD
Manhattan Plastic Surgeon

Best option for stubborn belly and flanks fat on healthy 40 year old.

Thanks for the questions and photo. I recommend Smart Lipo with traditional liposuction clean up of the melted fats. I would use the MPX unit on it's highest setting for the better skin contraction. As for a tummy tuck whether mini or full, I can not be sure if you are a candidate for those operations from only one photo. For sure not a full tummy tuck, but maybe a mini TT. Forget about these injection therapies (mesotherapy, lipodissolve, carboxytherapy) or cool laser light therapies ... more

Darryl J. Blinski, MD
Miami Plastic Surgeon

Things that sound too good to be true still are...

Hi there- Let's understand something.... You're pursuing this, and have asked this question, because you are interested in looking your best, right? I bet it's also safe to assume you are interested in keeping yourself safe and avoiding injuries or deformities you may regret the remainder of your life. For Heaven's sake, PLEASE do not let anyone inject chemicals under your skin (mesotherapy, lipomelt, etc)... Because I assume your goal is to get the best possible outcome, I would advise you to more

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Laser Liposuction may tighten

There are many ways to skin a cat! You are very skinny and the upright photo does not reflect the degree of skin excess as effectively as the sitting photo. I caution you to do liposuction as the flap of skin you have is very thin already and if the flap is made too thin you will have more visible irregularities. Also, considering the fact that you skin is loose , you may be disappointed in the lack of contracture of the skin. This is where the physical exam is very helpful. If the... more

Kimberley O'Sullivan, MD
Boston Plastic Surgeon

Fine tuning your abdomen with liposuction would do great.

You would benefit with the fine tuning that liposculpture does to your abdomen. It is easy and not overkill as a tummy tuck would be nor unsafe as those mesotherapy sessions are.

David Hansen, MD
Beverly Hills Dermatologic Surgeon

Many options for your belly

Obviously you fall into a catagory that has no "right" answer, given all the different opinions you are getting. The final answer lies in what you want and what you are willing to do and give as a trade. If you want your skin as tight as possible you will need to do a traditional tummy tuck. Downside:recoevry time and scar, relatively higher complication rate If you are willing to compromise some upper abdomenal skin loosenes the a mini tummy tuck with liposuctioning would work... more

John P. Stratis, MD
Harrisburg Plastic Surgeon

Tummy Tuck vs Liposuction

I agree that your only options are tummy tuck or liposuction. I would steer clear of the other suggestions. Without an exam it is difficult to state with certainty which is the better procedure for you. I feel that a tummy tuck will generally give you a better result if you have sufficient extra skin. I would suggest another consultation with a Board-certified Plastic Surgeon.

John Whitt, MD
Louisville Plastic Surgeon

Options for improving the abdomen

We can tell only so much from a picture, but it does appear that you have very little excess fat and mild skin laxity. With so little fat, liposuction is hard to justify although there may be some that isn't well shown in the photo. An abdominoplasty sounds extreme to me based on what I see but then I haven't examined you personally. I definitely agree that mesotherapy is very controversial and carboxytherapy is not well proven. The technology with the longest track record in the U.S. is... more

Richard Baxter, MD
Seattle Plastic Surgeon

Can you benefit from liposuction

There may be some refinement that can be provided via conservative liposuction. As your photograph does not reveal three dimensionality as well as an examination, I can not comment as knowledgeably without determining the amount of subcutaneous fat that exists. Thee may be external ultrasonic treatment that might give you improvement without surgery, but this device is in the final FDA testing process and there is no mention as to when it might be approved. The same is true for a cold energy... more

Ronald Shelton, MD
Manhattan Dermatologist

Great tummy

Dear Humm A tummy tuck is preposterous. Your tummy is awsome. Why would you want to put a scar on it that extends from one hip to the other? Only a mysogynist would recommend this type of procedure to you. I would also discourage mesotherapy. On the other had, a judicious tumsecent liposuction will help you tummy and flanks with virtually no blood loss and virtually no down time and the procedure can be done under local anesthesia. However, you will expereince limited improvement and no... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Invasive and non-invasive options for belly and flanks

You appear very fit, with a stubborn little pooch of fat on your belly and flanks. For non-invasive options, you should consider the Zeltiq cryolipolysis procedure. It is a reliable method of contouring small, focal regions of fatty deposits. It is available in the US, however is not FDA approved for this indfication, and is used off-label for body contouring purposes. Liposuction done very carefully using thin cannulas with attention to maintaining an adequate amount of subcutaneous fat... more

Scott Sattler, MD
Bellevue Plastic Surgeon

Tummy Tuck versus Liposuction

You're receiving varied opinions because you do have some options, and the right one for you depends on what bothers you. If the loose skin really bothers you, then a tumym tuck is recommended. However, you look in this photo as if you have so little extra skin that I suspect a tummy tuck will be difficult to perform. If little areas of extra fat bother you, and I don't see many of them, then liposuction is appropriate. You could also consider one of the newer liposuction techniques,... more