Hourglass Tummy Tuck—Is It Achievable?

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Hourglass tummy tuck is another fancy term for abdominoplasty, a body contouring surgery in which the appearance of protruding abdomen is corrected with a combination of techniques.  It is important to note that most patients will need more than skin removal.


After massive weight loss or pregnancy, the skin is not just stretched out.  Other factors that contribute to the protruding abdomen include the splayed or weakened abdominal muscle and the excess fat (which may not respond to exercise and diet).


It is important to note that the result of tummy tuck, despite its impressive contouring effects, will still largely depend on the patient’s underlying anatomies—particularly relating to the “narrowing” effect on the waistline.


In general, women with more distance between their hips and the lowest rib can achieve a more “hourglass” effect on their waistline compared to individuals with a markedly short distance between these two points.


Of course, the surgeon’s skills and experience will also make a huge difference. 


Contrary to popular belief, tummy tuck not just involves removing the apron-like skin.  In fact, overdoing this thing can spell disaster—i.e., overly tight appearance, unnatural transition between the lower abdomen and the mons pubis, unfavorable scarring, just to name a few.


Simply put, the amount of skin removal should still allow for proper wound closure.  The goal is to place the hip-to-hip scar very low that it is easily concealed by the patient’s two-piece bikini or underwear.  Over time, this scar fades into the background and its width becomes almost as thin as a human hair.


One of the most critical aspects of tummy tuck is muscle repair.  The idea is to tie together the pair of loose muscle that runs between the breastbone and the pubic region for a smoother, flatter effect.  I have always preferred the individual stitch to the use of one long continuous suture technique because of the additional strength the former gives.

For a more hourglass effect, I sometimes incorporate liposuction of the flanks to remove the fat rolls.

Article by
Beverly Hills Plastic Surgeon