What surgeries/procedures are best for my larger upper body?

Question

I have a masculine physique and my natural rested body are the first two images. I really hate it and lately I've been crying for days on end bc I'm down to 97 lbs and I still look big/masculine. I want an hourglass figure and narrow shoulders/thin arms. I thought abt rib removal or hip augmentation but I really don't know. I've got a wide rib cage, no hips, and fat arms. The other pics are obviously not achievable but I'd like to get as close to those reference pics as possible. Please help!

Jason Emer, MD · Answer

female 360 lipo with fat grafting to the hips and j plasma to stomach, inner thighs, arms can give you a more lean, slender look with shaping.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical optimization with hormonal therapy (see link to help boost their weight loss before surgery and help them heal after).

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Connie Hiers, MD, FACS · Answer

You showed no photos, but I suspect you are much too hard on yourself and need to accept yourself for the beautiful person you are.  Be grateful of who and where you are.

Mats Hagstrom, MD (license on probation) · Answer

I think you have an attractive feminine body that appears slim and fairly ideal.

To me you do not appear masculine and your upper half does not appear large or disproportionate.

I think you’re being extremely hard on yourself.

From my perspective your body physique is fairly ideal and the cartoonish large hips and curvy figures that patients are currently seeking is a bit of a fad.

Likewise, I think your arms are nicely slim and appropriate to your body.  continue staying healthy and appreciate the body that you have.

You shouldn’t have to look too far to see others who were given a body that is less desirable.

I personally cannot think of an appropriate procedure that you need. The only option for reducing your torso is liposuction but you don’t have enough fat for that procedure to make a significant difference.

Best,

Mats Hagstrom MD

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