What is currently the best way to eliminate fat in stubborn areas, when there isn't enough for Liposuction?

52 yo woman, fairly thin, but all my life have had belly fat. A doctor said there wasn't enough there to do it liposuction well, that you would see the scapula marks. She said a tummy tuck would be better because my skin is somewhat loose also. (At one point in my life I was sick and gained/lost 50 pounds which probably caused it, as I've never been pregnant.) But I wear bikinis and don't want a scar. I can grab two handfuls of fat on my middle abdomen and half handfuls on the upper.

Doctor Answers 10

Liposuction vs. Tummy Tuck

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Thanks for your question.  Without an examination, it is really difficult to say what would help your specific situation.  If you do really have loose skin, then the best way to address it would be with a tummy tuck.  Liposuction could be used to get rid of excess of fat only.  It is just important not to do both liposuction of the abdomen and tummy tuck at the same time because that could compromise the situation for the skin flap.  If you really do not like the idea of a tummy tuck, then maybe getting a second opinion with another Board Certified Plastic Surgeon to ensure it is a loose skin problem as opposed to excess fat.  Best of luck!

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 67 reviews

Lipo on Tummy

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Hello and thank you for your question! However, without seeing photos, it is difficult to say exactly which procedure is or isn't right for your needs to help you achieve a pleasing outcome. Generally speaking, you can have limited liposuction on most areas of the body. And a board certified plastic surgeon who is well trained with extensive experience can help you achieve your desired outcome. Please make sure you schedule an in person examination with a board certified surgeon. Best wishes to you!

Michael K. Obeng, MD, FACS
Beverly Hills Plastic Surgeon

What is currently the best way to eliminate fat in stubborn areas, when there isn't enough for Liposuction?

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Hello dear, thanks for your question and provided information as well.. This is the surgical procedure that revolutionized cosmetic surgery becoming one of the most performed cosmetic procedures. Subcutaneous tissue or fat is removed in order to contour the body in a way that is harmonious and pleasing to the senses. It can be performed in almost all regions of the body such as the neck, chin, abdomen, back, buttocks, thighs, arms and ankles. Usually done through a small incision in the skin through which a cannula connected to a vacuum is applied, it can be performed alone or in combination with other procedures. After liposuction your body is going to be really swollen for at least 2 to 4 months after your surgery. It is important for you to wear your compression garment for at least 6 months, the first 3 months 24/7 and then the last 3 months at least 12 hours per day for your body get use to not having the faja for so many time. When you remove it, your body can get swollen and also you can have pain. Remember to also compress your body to prevent a seroma which is an accumulation of liquid that has to be drained, it is hard to touch and also really painful. Bruises are completely normal for almost 3 months from surgery, that’s why is better for you to use a bruising cream and apply it all over your body 3 times a day. To prevent bad circulation and swollen legs, use compression socks. Brazilian butt lift can be performed with the same procedure and for a month it will be swollen and it will drop a little bit without losing it’s shape if you use your garment.. If you’re going to perform liposuction on your inner, outer, anterior, lateral, postetior thighs, be careful and consult with your surgeon what’s best for you, sometimes we have more extra skin than fat, that can cause severe sagginess on our legs, which can be only be reversed performing a thigh lift…

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 442 reviews

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SmartLipo may be the solution

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Thank you for the question.

It is impossible to give you an accurate assessment without a consultation.  If you post images of your abdomen - the answers may be more accurate.

That said, if you have minimal skin excess when you are standing and moderate bulges of fat, SmartLipo can be used to remove the fat and tighten the skin up to 20%.

It is a simple procedure, done through a couple 3 mm access sites.  It is usually done under local freezing and light sedation.  You will be back a work in a day or two and at the gym in 2 weeks.

Best of all, there is no scar so your choice of bikini will never be an issue and changing in the gym will never reveal your procedure.

Look up a member of ASAPS in your area who has extensive experience in SmartLipo.

All the best.

Scott Barr, MD, FRCSC, Plastic Surgeon

Scott Barr, MD
Sudbury Plastic Surgeon

Alternative Options for Eliminating Fat

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Hi qofmiwok,
Thank you for your question.

I recommend SculpSure, non-invasive body contouring to my patients who want to target troublesome areas. 
The advantages:
  • Target smaller, trouble areas
  • No incisions, no downtime
  • Return to exercise and normal activities immediately
The disadvantages:
  • May need multiple sessions
  • Less noticeable, less dramatic
I suggest seeing an experienced liposuction surgeon for an in person assessment to go over treatment options and desired results. Good luck with your procedure!

Jeffrey A. Klein, MD
San Juan Capistrano Dermatologic Surgeon

Tummy tuck vs liposuction

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Photographs would be very helpful but given your age and description of "handfuls of fat" I believe your surgeon may be right.  If you had liposuction only, the excess skin would still be present and "hang" more.  Also in someone who has had a 50# weight loss you may also have laxity of the abdominal wall giving some fullness to the lower abdominal area as well.  This can only be corrected with surgery.

I recommend getting several other consults from board certified plastic surgeons to help make your decision.  Usually the scar from a tummy tuck is low enough to be covered by most bikinis.

Good luck,

Dr. Luong

Jacqueline Anne Luong, MD
Edina Plastic Surgeon

VASER Hi Definition Liposuction / Body Contouring Vs. Non-invasive such as SculptSure, CoolSculpting

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Please post photos for further evaluation. I suggest a 4D HI DEFINITION contouring specialist if you want fat removal and contouring. Excess skin can be removed during this procedure.  An in person consultation is needed to determine what is best based on your body and skin type. Non-invasive procedures such as SculptSure only work to remove about 15-20% of fat per treatment. Please seek an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

What is currently the best way to eliminate fat in stubborn areas, when there isn't enough for Liposuction?

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Sounds like a loose skin problem possibly with muscle relaxation and some abdominal protuberance due to internal (or visceral) fat.  If there's not enough for liposuction other non-surgical devices (ie iLipoXcell) are not likely to be of much benefit.
If you can currently wear a bikini I'd also assume that your problem is relatively minor and a tummy tuck or mini tummy tuck may not be needed.  If there's lots of skin looseness then consider a tummy tuck and recognize that bathing suits will be needed that cover the incision lines.
Good luck with your decision.

Jon A Perlman MD FACS
Certified, American Board of Plastic Surgery
Extreme Makeover Surgeon ABC TV
Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Tummy tuck or liposuction for belly fat?

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Thank you for your question about your liposuction or tummy tuck.
  • First - without photos one truly can't be sure.
  • But if you have loose skin - and it sounds as though you do - your surgeon is absolutely right.
  • A tummy tuck will remove the excess skin 
  • It will tighten the muscle and do liposuction for contouring as needed.
  • If you do liposuction with loose skin, you will see looser skin and cannula track marks.
  • It sounds as though your choice is a scar you don't want and a good result or tiny scars and a disappointing one... but without at least some photos, this is 
  • Always see a Board Certified Plastic Surgeon.
Best wishes. Elizabeth Morgan MD PHD FACS

What is currently the best way to eliminate fat in stubborn areas, when there isn't enough for Liposuction?

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I think your doctor was probably right. You cannot grab handfuls of fat unless there are also handfuls of loose skin. But without photos there is no way to give you specific advice. There is no reason you can't wear a two piece swimsuit after a tummy tuck by a skilled surgeon who understands how to keep the scar low. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 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.