Waist After Lipo? And Just Lipo or TT? (photo)

my waist used to be 26 in now it is 33. Is it possible to get it back down to 33in? Will I need TT with muscle reconstruction to get it back to where it was? What can be acheived realistically?" I do not know. If I have muscle separation but I have had 5 children. I push into my stomach to do the test but it does not appear to be any gap. I used to be very muscular so that can play a big role as to whether or not I have weak muscles. I usually snap back but not after the last pregnancy. I didn't exercise befor of after that child for a year ( before and after). Do I look like I have separation?

Doctor Answers 9

Liposuction versus Abdominoplasty

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Hello and thank you for your question and photos! As some of the previous plastic surgeons have stated, it would be the most ideal to try and obtain your optimal weight and then re-evaluate the situation.  I recommend that my patients who need assistance in reaching their goal weight see a medical weight loss and bioindentical hormone restoration specialist.  I feel that once you are at your optimal weight, you will be better able to evaluate what procedure you need to help you reach your cosmetic goals.  The tummy tuck does assist in re-creating your "inner girdle" and will give you a shapelier midsection by tightening the tissue that holds your abdominal muscles together.  I wish you the best of luck!

Lone Tree Plastic Surgeon

Tummy tuck or lipo

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Some patients are candidates for both procedures. It just depends on what you are trying to accomplish, what scars you are willing to live with, how much time you can take to recover, etc. A tummy tuck will do more for you since the muscle will be tightened, skin will be tightened, and excess fat is removed. However,  it is also possible that you will be satisfied with lipo only. This is something you need to discuss with a board certified plastic surgeon. For patients who have moderate to large amounts of excess loose skin, only a tummy tuck will give a good result.

Paul Wigoda, MD
Fort Lauderdale Plastic Surgeon
4.8 out of 5 stars 30 reviews

Tummy Tuck and Liposuction or Just Liposuction

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   It is possible that liposuction alone will produce a significant change in waist and abdominal contours.  However, a physical exam would be necessary to determine this with any degree of certainty.  Find the plastic surgeon with ELITE credentials who performs hundreds of tummy tucks and liposuction procedures each year.  Kenneth Hughes, MD Los Angeles, CA

Waist After Lipo? And Just Lipo or TT

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Thank you for your question and the attached photo. A side view would also be useful.

Liposuction will only remove fat, and is ideal then that is the only issue. A tummy tuck can also remove excess skin and can tighten the abdominal wall. 

I will assume that you may have weighed less when your waist was 26 inches. A tummy tuck and or liposuction cannot decrease the volume of the intra-abdominal contents, and that is a key factor in the waist size.  

As to the muscle separation, it cannot be determined from this photo alone.

Best option is to consult with a plastic surgeon who can offer whichever procedure or procedure that is most suitable. 

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

How to Check for Muscle separation after children

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Thanks for your question. It is one of the ones I am asked most frequently  The best way to test for muscle separation (diastasis) is to lay flat on your back and first pick up your legs off the ground. Now look and feel just below your belly button towards your pubis. If you see a bulge or can feel a "valley" oriented vertically the you have lower abdominal Rectus Diastasis (or separation of your muscles). Repeat this in the upper tummy by lifting your head and feeling. Exercise may improve but not totally correct this condition. A good repair during your tummy tuck will do this for you!

Another test is for the quantity of fat "inside" your belly that we cannot get to either by liposuction or tummy tuck. This "organ fat" can be checked out while laying on your back. Look at the contour of your stomach. if it is concave (like a bowl) then you have little or modest amounts of this hard to treat fat.  Surgical intervention in the cases that have a lot of internal fat yield less than ideal results. I hope these tips help you with your decisions. Best way however is to get a consult with a board certified Plastic Surgeon!

Manuel M. Pena, MD
Naples Plastic Surgeon

Waist After Lipo? And Just Lipo or TT?

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It is very hard to say from the photos alone; you would need a consultation in person to be assessed most accurately.  However, I would say the following in general:  First, congrats on the five children.  But it is unlikely that you'll be able to get "back" to what you were - regardless of what you do.  You can get a significant improvement with a procedure (you may need a lipo or a tummy tuck with muscle repair or, in some cases, both procedures, to get the maximum effect).  Improvement; yes.  Back to what you were?...probably not.

I hope that this helps and good luck,

Dr. E


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The only way to determine if you have a separation or a diastasis recti is with a physical examination in the office

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon


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I do not think liposuction alone will do what you want. I think you will be happier if you get back to your exercise program, and lose a small amount of weight, and then go see a PS and discuss your abdomen. After an exam it may be decided that a tummy tuck is a better option, and he will be able to tell if you have muscle separation.

Tummy liposuction should make a huge improvement in your waist.

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Liposuction of the tummy is easy to undergo and should make a huge improvement under local tumescent liposuction for roughly $5-6000 with you getting back to work in 2 days and back to the gym in 1 week.  Sincerely, David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.