Why do some people have a boxy, round shape to their mid section after a tummy tuck? (Photos)

Question

I have a short torso and having a box shape is one of my biggest fears. My ps is not going to lipo my flanks he is only going to lipo my upper stomach.

George Marosan, MD · Answer

Thank you  for your question and photos. It is impossible to determine from these pictures if you have a lot of fat over the abdomen, or lots of muscle laxity. If the second condition is true, then you need VASER liposuction of your whole back, waist, hips and abdomen with a tummy tuck; otherwise you will not achieve an hourglass figure. A little suction on abdomen or flanks will give you little improvement. If you have a thick layer of fat over the abdomen, than I would do VASER Hi Def lipo of your whole torso followed by an abdominoplasty 4-6 months later. Seek consultations with other plastic surgeons who have extensive experience in advanced body sculpting techniques. It sounds that your chosen plastic surgeon is very conservative (nothing wrong with that), but you will need further surgery if your goal is an hourglass figure. You have to decide how you "wish" to look and seek out a surgeon who can deliver your wish. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you are a great candidate for a tummy tuck with liposuction.  In order to accentuate an hour glass shape, I would recommend liposuction of your flanks.  A tummy tuck can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Dhaval M. Patel, MD · Answer

Thank you for your post. Typically, to achieve the best results in patients with excess fat in the abdominal area are to liposuction the upper and lower abdomen in combination with the flanks to give you a flat stomach as well as a nice contour. It's best to have a thorough in person consultation with a board-certified plastic surgeon in your area to discuss all of your treatment options. Best of luck!
Dr. Dhaval M.Patel
Double Board Certified Plastic Surgeon
Chicago-Water Tower Place, Oakbrook, Hoffman Estates, Orland Park

James A. Hoffman, MD · Answer

A Tummy Tuck without the Liposuction of the flanks will certainly leave you with a boxy look. You would benefit greatly from Liposuction in this area. Keep in mind the extra time it takes to deliver a great shape will add to your cost and the surgeons time.  I recommend seeing 2 or 3 Board Certified Plastic Surgeons in your area. Be prepared for some cost differences in order to get the look you desire. Best Wishes.

Jack Peterson, MD · Answer

I would recommend you have liposuction of your flanks as well and an extended abdominoplasty.  You would have a longer incision, but your contour over the hips and flanks would be much improved. I would suggest you be at a BMI of 30 or less as that will also improve the contour of your upper abdomen as well as decrease surgical risks

Maida Parkins, MD · Answer

For most patients I do recommend lipo of the flanks along with a tummy tuck, unless they really don't have any extra fat in that area.  The tummy and flank is one continuous area so you don't want to have a nice flat tummy and still have stuff rolling over your jeans in the flank area.   I think doing some lipo in the flanks helps reveal your hourglass shape and take away the boxy look.  Best wishes!

Jon A. Perlman, MD (retired) · Answer

A large factor that determines how much of an hourglass shape you can have is your natural muscle contour.  Tightening your muscles and liposuctioning the flank area will allow for the maximum contouring possible when combined with removal of significant amounts of skin and excess fat. How much if any fat is there to be sculpted can only be determined by a face-to-face exam.  Upper stomach fat can only be thinned to a degree at the time of a tummy tuck to avoid affecting circulation to your skin, and some patients benefit from preoperative weight loss whereas others less frequently require a minor secondary liposuction under local anesthesia (to provide further thinning of the upper stomach). Your photos do suggest that you have potential significant gain from an abdominoplasty and liposuction procedure but you can optimize the outcome by getting to a healthy maintainable weight before surgery.  This will enable your surgeon to tighten your stomach muscles more effectively and give you a better outcome from your procedure.Please enjoy the video link below and best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

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