What Area is Considered to Be a Normal Flank Region?

I am going to have Smart Lipo on my flanks, however, I questioned whether an area of my back is still considered part of the flank or a bra-line. I, mistakenly, wore my bra too low for years due to attempting to cover up the original bra line. A 2nd roll appeared, due to this and pregnancy. It is technically the top of my flank, right at the bottom of the ribs, a good 2 inches below my shoulder blades. I have since corrected how I wear my bra, but that extra roll still exists. I have a consultation with the surgeon next week, but the manager believes it would be considered a separate area to treat, but wants the surgeon to look at it. I disagree because of pure anonatomy and the fact that the roll goes right down my flank on the sides as well.This will double the price on the procedure if they flag it as the bra line and not the flank. In the industry, what area do they consider to be a normal flank region?

Doctor Answers 13

The flank is a common area for liposuction

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Most surgeons consider the flanks to be the area of the lower back below the rib-cage and down to the iliac crest; this area is commonly referred to as "love handles".  I would consider upper back rolls or back fat to be a separate area and would not be included in treatment of the flank.s  Typically this would be considered a second area of treatment and can be safely performed at the same time as the flanks, but it does require additional incisions and additional time for the surgeon to complete. Both areas respond very well to liposuction.  I currently prefer to use SmartLipo Triplex because of the quicker recovery, less bruising  and swelling, additional skin tightening,  and patients  are more comfortable after the procedure. If you really want both areas treated, it is much more cost effective to have both areas treated at the same time and should not double your cost.  Good luck to you.

Grand Rapids Plastic Surgeon
5.0 out of 5 stars 72 reviews

Communication with your Plastic Surgeon is the key to great results

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Hello SGBsMom, Liposuction is an excellent way to contour these troublesome areas. I prefer tumescent or ultrasonically assisted liposuction (UAL) for these regions. Although the flank and bras strap area are not strictly anatomical terms, most physicians make a distinction when it comes to liposuction. It is preferable to treat regions (bra strap area, back, flanks) rather than to spot treat areas (flanks). This gives a much more balanced and harmonious appearance. I generally blend in areas, such as the flanks and bra strap area and back, but if full correction is requested this is considered a separate area. At the time of your consultation visit, discuss your goals and together, you and your surgeon can put together a treatment plan. The number of areas, as well as the financial policy should be clarified at the time of your consultation. I would recommend treating all of the areas which you are concerned with at the time of surgery, rather than risk being disappointed and having to undergo another procedure. Be well, Andrew Lyos, M.D.,FACS

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 65 reviews

Know what is included in liposuction procedures

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Many doctors try to discuss liposuction in terms of the desired result and use terms such as flank very generally. No one can really say where the abdomen stops and the flank begins, or the flank stops and the back begins. Some surgeons will break up the trunk area into smaller or arbitrary areas to help them with pricing or as means to up sell; start a discussion as a seemingly low cost which is very attractive only to have the cost creep higher as you discuss with them what your goals are.

During your consultation it is best to have the surgeon acknowldge and mark out exactly what the treatment area will be and discuss with you the expected result. look at the cost from the bottom line. The total cost is the cost for what you are seeking. If adding an "area" in order to get the results you hope for places you on top of what you can reasonably afford I feel you should wait until the additional cost is managable to you, or find another surgeon in your geographic area who is more flexible and result oriented.

A surgeon who is result oriented will work within your budget yet go the extra mile or "extra area" because the result will be right for you.

Best of luck.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Flanks are the area just below your waist.

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The goal of liposuction in this area to increase the contour of the waistline.  The excess fat below the bras sits just above the waistline.  This area is actually more difficult to treat than the flanks and is anatomically separate.  The fat can be more difficult to get out and you may be left with some loose skin.  It is extremely unusual to get loose skin after liposuction of the flanks.  

Flank vs upper back roll

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The flank usually refers to hip rolls and not upper back or bra rolls. Either way, you should talk to your surgeon and work something out to have it treated if that is waht bothers you.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Liposuction of the flanks

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Liposuction is a safe, popular, and effective way to contour the body. The area of the flanks is the area on the side of the abdomen usually from the waist up to just below your bra. This area to be treated very effectively with liposuction.

The flank is not a medical term

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It is important to have clear communication with your surgeon and the surgeons office. A flank is somewhat in the eye of the beholder. Generally, I consider the flank as the area roughly between the lower ribs and the top of the hips. It is where the hour glass shape should live at the waist.

Typically, we include in this zone the fat that extends from this area toward the spine to help fully shape the waist. Now, I would have absolutely no disagreement if another doctor wanted to define the area somewhat differently because the term is not a technical medical term with an agreed upon definition.

The areas you are interested in having additional liposuction overlies the large latissimus dorsi muscle. Honestly, this is an other quite large area with very fibrous fat which requires a greatly deal of effort on the part of the doctor to make a nice difference. I think it is very reasonable if your surgeon and his office consider this an entirely separate area. For some doctors, this is considered quite separate from the "flank."

So again, my advice is to talk with you doctor but don't be surprised if this issue is considered outside of the flank. However, generally the incremental cost to have an additional area done is reasonable and if it bothers you, I encourage you to have this addressed at the time of your liposuction.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

In laser liposuction, the flank is the waist area above the hip bone, not the bra area

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Dear SGBsMom,

The flank is usually considered the area of the waist just below the rib cage down to the top of the hip bone. It is very close to the area of skin just below the breast.

Most surgeons do consider the "roll" beneath the bra a separate area, often called the "bannana roll."

Laser liposuction of the back and area beneath the bra adds significant time to the laser liposuction procedure-your body has to be turned and repositioned, and the back tissues are harder to treat. The extra time and effort involved increases the cost of laser liposuction which includes anesthesia, or room use, nurses, and surgeons time.

In my practice we have a base fee for laser liposuction of one area, say the abdomen.

We then add a reduced fee for each additional area. Two areas should not cost twice as much as one area, in my opinion.

Flanks - Area Between the Bottom of the Ribs & Top of the Hips

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The vast majority of plastic surgeons define the flanks as the area between the bottom of the ribs and the top of the hips. This terminology is less important than the patient’s specific anatomic findings and aesthetic goals and sometimes contributes to confusion. It’s always better to treat the anatomic problem as opposed to the anatomic area.

For these reasons, good communication between the surgeon and patient is an essential component of quality care when performing liposuction.

If you’re considering liposuction, it’s important to consult a board-certified plastic surgeon. This surgeon should be able to illustrate which areas will be treated during this procedure.  

The area you are describing is not the flank

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The area you are describing is not the flank. There is no strict definition for the flanks; however, when it comes to liposuction, the flanks are generally considered the area that you can grab with your hands above your hip bones. Just because you have a roll that goes into the flank area does not mean that this entire area is now considered the flank. In any case, it is up to your surgeon to decide. If you are not happy with their answer, then I would suggest getting a second opinion. However, the area you are describing would likely be considered an additional area by anyone performing liposuction. Good luck with your surgery.

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.