I am looking into getting liposuction for my abdomen (Photo)

Question

I am looking into getting liposuction for my abdomen but was told I should include my waist as well. I want to know if I did only my abdomen, would my body end up looking disproportionate? I honestly like how thick my waist is, but do not want it to look weird. I am currently trying to lose weight while I look more into lipo. I feel like doing the back fat would help without having to do my hips. The only place I've had a consult at is with Sono Bello.

George Marosan, MD · Answer

Thank you for your question and photos. Based on your photos, you have excess fat on your abdomen, anterior and lateral rib cage, full back, waist and hips and significant bra rolls. Liposuction of your abdomen only, will leave you "weird" as you said. Body sculpting with liposuction has evolved from a two dimensional fat reduction procedure to a three dimensional surgery where the whole torso is addressed to create athletic, feminine hourglass figures. This is a paradigm shift in thinking and doing total body transformations with liposuction and or liposuction and abdominoplasty.  I agree with Dr. Hagstrom's assessment and explanation about Sonobello. Because of places like that,  over 60% of patients I see had previous poor surgery and some cannot be fixed or returned to normal. 
See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. BTW, do not commit to surgery until you are at your desired weight.
See attached web reference.

Richard Zienowicz, MD · Answer

Hello and thank you for your question. I do agree with others that you will have an overall more natural-looking, cohesive result if you liposuction the back and flanks with the abdomen. This way, the waist can get as contoured as possible and it won't look unnatural in the sense that you will have a flatter, more contoured abdomen and have volume on your back that was left untreated and looks different than your front.

Jason Emer, MD · Answer

if you have loose skin you will need skin removal and/or internal heating.

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.

Daniel Barrett, MD · Answer

Dear Tough349348,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from liposuction. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Manuel Diaz, MD · Answer

Good evening, according to your photos you are a good candidate for liposuction which would help you to shape your silhouette, but first before undergoing liposuction I suggest you finish losing the weight you want and make sure you contact a surgeon certified by the Council.
luck

Cem Payasli, MD · Answer

Hello,

Thank you for sharing your question. I think if you want to get a proportionate and fit figure, you should consider liposuction for your upper and lower abdominals, waist, and back.

To give you more information, online consultation is required. Please feel free to contact me. instagram.com/drcempa

Best regards, 
DR. CEM PAYASLI 
MEMBER OF INTERNATIONAL SOCIETY OF AESTHETIC PLASTIC SURGEONS

Mats Hagstrom, MD (license on probation) · Answer

In my practice I would most likely not offer Liposuction on just a front of the abdomen.

From an aesthetic perspective I view the torso as a single anatomic unit and typically treat the entire torso if I’m going to do liposuction.

There are exceptions like patients who’ve had a tummy tuck where the front was adequately treated through that procedure but left their sides glaringly large and bulging because they were not included in the procedure.

The best analogy I can give you is painting one wall of a house a different color and ignoring the other sides of the house.

Perhaps somebody wants to have one green side of the house while  the other sides are yellow. Perhaps they are OK with that but what about the neighborhood? Others are going to look at the house from all different angles and it will be out of balance and an oddity in the neighborhood.

The idea of treating the torso as a single unit becomes more important the more body fat someone has.
The reason for this is the more fat someone has the more of a change is possible from Liposuction.

This makes the transition between treated and non-treated areas much more obvious.

In your case I would not offer Liposuction of just the front of your abdomen. In fact in my practice I don’t offer that as some thing patients can schedule. (there are exceptions). We sell the “full torso” as a single anatomic unit area. Technically a full torso includes upper abdomen, lower abdomen, love handles/hips, waist, back and under arm.

When not subdividing the torso into many different small areas patients do not feel like they’re being up sold  or have to make decisions that balance financial cost versus ideal results.

I personally am not interested in leaving patients looking half treated. The results from each and every patient is a reflection of my work and who I am.

For that reason unless someone is on board with doing the right thing I typically suggest they find a different provider if they ask for a treatment combination that doesn’t make sense to me.

Sono Bello is the largest cosmetic surgery company in the world.

They use highly aggressive commission driven sales people with zero medical background to do their consultations.

I’m guessing  they most likely told you you should treat your upper abdomen, lower abdomen, hips and waist.

The yelp reviews for Sonobello in Las Vegas are surprisingly good.

If you look at yelp reviews for that company in other cities like the one in our neighborhood they have some of the worst reviews of any medical clinic in the cosmetic or plastic surgery field.  in fact the reviews typically are some of the worst of any business in the community.

For example the Sacramento center has an average yelp star review average of 2.5. The Sacramento Sonobello clinic has been open a little longer so they have over 100 reviews.  Looking through the reviews there is one section where they have eight consecutive one star reviews.  The reputation of this Company has been earned by behaving unethically and doing shady practices for many years.

This is not to say that occasionally they don’t have a qualified plastic surgeon or two.  I personally would never commit to having a surgical procedure without meeting the surgeon who’s going to do my procedure in person unless it’s an emergency and I have no choice.

Liposuction results are permanent and irreversible.

In your case I would encourage you to have consultations with multiple providers including plastic surgeons in private practice.  in general I would encourage patients to avoid large corporate outfits though sometimes talented plastic surgeons do work for these companies.

Since companies like Sono Bello offer a very small percentage reimbursement to the surgeon one would have to ask why someone would choose to work for a company like that?  typically doctors who cannot make a living running their own practice or are just out of training find corporate employment fertile grounds for being able to keep your mortgage payments going.  I speak from first hand experience.

Most plastic surgeons are probably going to recommend some thing often called abdomen 360.

This most commonly includes upper abdomen, lower abdomen, love handles and waist.  Sometimes it includes part of the back and occasionally most of the back.

I’m not a fan of the term abdomen 360 because it’s a bit vague of what is or is not included. The term began in popularity because of the importance of including the backside with the front or in other words going all the way around.

I shared previously my approach.

Treating  only your upper and lower abdomen will not leave you with a natural fat distribution.

Sonobello may offer you a surgeon who is experienced and talented, who delivers good results but the company is renowned for leaving patients disfigured and abandoned.

The following are some general personal recommendations for patients seeking cosmetic surgery to help get the best results and have the overall experience be a positive one.

I recommend patients avoid traveling long distances for elective surgical procedures. There are of course instances where there is a lack of local talent and traveling to some degree is inevitable. If traveling for the procedure patients should be ready to travel to have the consultation, post operative appointments and follow up should there be issues or complications.
Patients sometimes do not appreciate the importance of in person consultations, that complications do happen or the number of people who have issues with their results or need revisions.

Schedule multiple consultations with different providers in your area who seem to have a good reputation for the procedure you’re interested in. Starting with at least five consultations seems like a reasonable number to me.

Whenever possible schedule in person consultations.  
During in person consultations ask each plastic surgeon to show all of their before and after pictures for the procedure you’re interested in.

The goal is not to see the best results of their career but to get an idea of what average results look like and get some type of confirmation of how many of these procedures that provider has performed.

Ask to see results that were not as good as the doctor would’ve hoped for and talk about the differences in outcomes. At Sonobello you should ask the individual provider to show their own results not the best results the company has accumulated by doing close to 100,000 liposuction cases.

Honest and experienced providers should have no problems presenting this type of information.

A highly experienced plastic surgeon should have hundreds of before and after pictures for the procedure you’re interested in. At a minimum they should be able to show you at least 20+.

Read all the reviews on various physician review websites paying close attention and avoiding providers with any significant number of justified negative reviews.  Providers with an abundance of reviews often have aggressive marketing campaigns.

The plastic surgeons I respect most all have the single variable of not having justified negative reviews on their online profiles. 
In my opinion justified negative reviews are far more telling than an abundance of positive reviews.

Avoid scheduling surgery or making a deposit on the day of the consultation.  Give yourself some time to think about the decision and make sure you finished all scheduled consultations before committing to having surgery that will permanently and irreversibly change your body.

When in doubt slow down and schedule more consultations.

Choosing the right plastic surgeon is the single most important variable to having a positive experience.

Don’t go chasing after technology or names of certain equipment. Instead focus all your efforts on finding the most experienced and talented board-certified plastic surgeon.

Best,

Mats Hagstrom MD

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and I would loose the desired weight first and then go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results and look at photos of similar patients and become fully informed about the desired procedure

Dr Corbin

Dr Corbin

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