How do Some Women Have a Hourglass Shape after TT/Lipo but Others Don't?

Thank you for sharing your question. Ultimately the final shape is dependent on the patient's underlying muscle and bony anatomy - pelvic height, width, distance to rib cage, etc. Hope this helps.

The final shape is due mostly to the patients anatomy vs the surgeons ability. Any good liposuction surgeon may achieve an hourglass shape on a patient provided that the ribs, muscles and hip bones are a proper orientation.
Some patients who gained significant weight bring in photos of themselves decades ago at much lower weight. The chest and abdominal/pelvic cavities can change greatly with large or extended weight gains and thus, their old shape is unobtainable. A physical exam answers this questions pre-operatively.
Best wishes.
Dr. Taranow