32, female. Best options to reduce fat bulge on rib flare area? (Photos)

Question

Hi, I’m a 32 year old female looking for advice on what kind of procedure could help with stubborn fat pockets over my rib flare area. I have a naturally short torso and have always struggled with this-- whether I’ve gotten leaner or gained weight, the bulge in this area stays the same. It doesn’t respond to diet or exercise and creates a noticeable protrusion that makes me feel self-conscious, especially in bras and bikinis. Bras tend to push down on the fat, making it more visible, but it’s still there even without them. I’d love to know what procedures (surgical or non-surgical) might help flatten or contour this area. Thank you! :)

Raffy Karamanoukian, MD, FACS · Answer

Body contouring procedures have become increasingly popular and can help men and women recontour their body in adulthood. If you have stubborn areas of fatty accumulation that are more resistant to diet and exercise, you may be a candidate for body sculpting liposuction performed at Kare Plastic Surgery in Santa Monica. Liposuction remains one of the most popular procedures in cosmetic surgery and allows patients to slim and toned their waist line, back, arms, and legs using this minimally invasive and highly coveted procedure.

Among the most common areas to have liposuction performed is the waist line and stomach area. This makes liposuction an excellent alternative to a tummy tuck or mini tummy tuck. If you have had fluctuations in weight, you may benefit by recontouring the waistline and abdomen using liposuction. Patient with excessive skin in the lower abdomen from childbirth or from excessive weight loss may not respond well to liposuction because the extra skin will continue to hang. In these patients, and abdominal plasty procedure is preferred.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Kyle Summers, DO · Answer

If there are true fat pockets and it’s not just from the rib flaring itself, then liposuction is the most effective treatment for stubborn fat pockets. Things like cool sculpting and other minimally invasive techniques are not effective and oftentimes leads to a rebound overgrowth of fat via a process called paroxysmal adipocyte hyperplasia.

Chet Mays, MD · Answer

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for Liposuction to get rid of stubborn fat or fullness to your upper abdomen. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can create a surgical plan that is best for you and your goals!

David Hansen, MD · Answer

Liposuction with Quantum/Morpheus would make a big improvement and is easy to undergo under local with a little iv sedation for complete comfort.

Camille Cash, MD · Answer

I encourage you to begin by visiting with a board certified plastic surgeon near you for an evaluation.  If the contour that concerns you is created by excess subcutaneous fat then liposuction of the area should help to improve the silhouette.  I've included a video that I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

The fullness, some women have just below the IMF (infra mammary fold). is often poorly understood and can be difficult to explain.
It’s typically not a variation in the thickness of subcutaneous fat.
It stems from certain connective tissue fibers that connect the scanner to the underlying muscle fascia.
We have these in different places of the body and in some areas there’s more connective tissue securing the skin to the underlying muscle structure then others prepare.
There is a row of connective tissue, securing the skin to the torso that goes from the midline back all the way. Most of the time this is seen as the back bra roll on women as they age and loose skin elasticity. That same fold that forms on the back of middle-aged women can also continue and show on the front between the IMF and the bottom of the rib cage.
Because it’s actually a skinfold even if it doesn’t look like a fold it doesn’t respond all that well to Liposuction.
I’m also not a fan of spot treating the torso with liposuction because it develops an unnatural fat distribution that doesn’t look normal.
 The best treatment for this happens during a full tummy tuck if the dissection between the muscle fascia and subcutaneous fat is carried high enough to release the connective tissue fibers.
I’m absolutely not saying you need a tummy tuck.
All I’m saying is when a tummy tuck is done and the dissection is continued up to the IMF. this “fullness on the lower chest” is corrected.
There is no simple treatment that’s effective.
It may be tempting to try Liposuction, especially for those who have limited experience with the procedure.
Partially treating the abdomen with liposuction, it will almost always lead to an unnatural appearance.
The fullness in this area simply happens on some anatomic variance or individual people usually women.
It’s poorly understood even by me and difficult to correct with the exception of a well done tummy tuck in my opinion.
I’m sure you’ll find different plastic surgeons with very different explanations and different approaches to correct this including approaches with far more enthusiasm than I am portraying.
My best recommendation based on limited information and without an examination is probably to do nothing.
You definitely should rely on in person consultations, and you should insist that providers who recommend surgery show you lots of before and after pictures of previous patients with the same body characteristics with good outcomes.
I would not schedule surgery for this until you have a provider who can clearly explain what the fullness represents, show you evidence of it being treated successfully on multiple before and after cases.
They can’t show you pictures. Don’t schedule surgery.
I suppose I’m getting a bit conservative with old age.
I’ve seen too many people be left disfigured from poorly done Liposuction to not heed a warning.
As I said, expect plastic surgeons to have different opinions, and most likely be far more enthusiastic about operating on you.
Be careful.
Mats Hagstrom MD

32, female. Best options to reduce fat bulge on rib flare area? (Photos)

Answers (6)

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