I am looking for a dramatic hip to waist ratio. Is this possible now or do I need to gain more weight? (photo)

Hello and thank you for your question.  I would not recommend intentionally gaining weight for this procedure.   Based on your photograph, you are a
great candidate for waistline contouring liposuction of your abdomen, flanks,
and lower back.  This can greatly improve your overall shape with a
smaller waist.  Make sure you specifically
look at before and after pictures of real patients who have had this
surgery performed by your surgeon and evaluate their results.  The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hi. The answer is yes. I feel you could have a great looking figure and slim down that waist. I wold not encourage you to gain weight. I would strongly suggest Vaser lipo. Vaser lipo is a highly specialized type of ultrasonic liposuction which requires years of exprience to become proficient at it. We have on our staff one of the leading prationers of this type of lipo and I encourage you to look into it.Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in Vaser liposuction. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits? 
How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.
How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications. You owe this to your family.
In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up.
Good luck, 
Dr. PG

Hi, thanks for sharing your concern and photos with us!
First I want to congratulate you for making this important decision. Deciding to get an aesthetic procedure to change your body and get a new life style is a big step!

Looking at your photos I might say that you´ll be a great candidate to get an entire abdomen, back, back and waist liposuction with BBL, this is because you have located fat that can be done with lipo.

Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine. For us your safety, always, is going to be first.

Have a great day!

Dr. JPG