Best options for hourglass waist, tight skin, and less fat? (Photos)

Question

Following two kids I did cool sculpting, exilis 360, and cool tone. I am still unhappy with abdomen. Considering a mini/full tuck or lipo. Worried about skin laxity. The skin above my belly button wrinkles - it feels as if my belly button should be up by an inch. Suggestions for best options for an hourglass waist, tight skin, and less fat?

Nelson Castillo, MD · Answer

Thank you for your question and series of photographs. Nothing replaces an in-person examination, but I think you would most benefit from a full tummy tuck and liposuction of your waist and flanks. The tummy tuck will tighten your stomach muscles, helping to achieve a flatter appearance, while removing excess skin and adipose tissue. Liposuction can be used to enhance your tummy tuck results by narrowing your waist and removing isolated areas of diet and exercise resistant fat. I would favor the full approach because it appears that your skin and muscle laxity is present above and below your belly button. Hope that this helps

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding how to get the best abdomen with an hourglass shape. Thank you for submitting your pictures. First, let's analyze your history and pictures: based on your history, you've already exhausted the conservative measures to improve your abdomen. Analyzing your pictures, you have stretch marks, loose skin, and abdominal muscle laxity. In my opinion, further removal of fat will just leave more excess hanging skin, Also, further removal of fat does nothing for the weak and underlying muscles due to your prior pregnancies. In my opinion, your best result would be obtained with a tummy tuck or abdominoplasty. An incision is made low on the abdomen, tissue dissection is carried up to the belly button and up to the rib cage. The muscles are plicated and flattened. The excess skin and fat is removed from just above the pubic region to the belly button. Also, skin and fat can be removed from the pubic region. Therefore with the tummy tuck, skin and fat are removed, the rectus abdominus muscles are plicated, and the belly button is reestablished. None of these maneuvers are achieved with liposuction except for fat removal. I would advise you to stop wasting your time and money on treatments that don't work and undergo the treatment that does work for your abdomen, namely a tummy tuck. I hope this information helps you to reach the conclusion that you need a tummy tuck. Thank you for your question and good luck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a great candidate for tummy tuck with flank liposuction. This can be done through a very low bikini incision and help you to achieve tighter skin, an hourglass shape and overall less fat. I hope this helps.

Sacha Obaid, MD · Answer

To achieve the best results, I would suggest a full tummy tuck with liposuction 360 and muscle repair.  This will help you achieve the hour glass shape and remove excess skin and fat.  I would recommend seeing a board certified plastic surgeon to discuss your results.  Good luck!

Leila Kasrai, MD, FRCSC · Answer

Loose skin can be removed with a tummy tuck. A full tummy tuck would remove excess fat and tighten loose skin in the areas above and below your belly button. Abdominal muscle separation can also be corrected at the same time. Combined with possible liposuction of your sides, you may be able to achieve more of an hourglass figure.

Jules Feledy, Jr., MD · Answer

Hello! Your photos indicate that there is skin laxity, excess volume, and outpoutching of the abdominal wall - all that suggest that you would benefit from a full TT. It is unfortunate that you have spent money on procedures (Cool Sculpting, Exilis 360, and Cool Tone) that were not likely to really impact you and get you to your ultimate goal. A Full TT will release the skin above your belly button and allow for abdominal wall tightening from the upper abdomen to the pubis. It is going to give you the most mid-abdominal tightening. It also allows the upper abdominal skin to be pulled down and consequently the lower abdominal skin is maximally removed. I do not think a Mini TT will help very helpful for you. A Mini TT goes from the pubis to the umbilicus (generally). The abdominal wall is tightened from the belly button down to the pubis and only the excess skin of the lower abdomen is removed. In your photos, you have excess skin ABOVE the belly button. You also have a little depression ABOVE the belly button which suggests the muscle separation (diasthasis) extends higher. Liposuction will only address the fat and will leave skin hanging. For these reasons, I think you will benefit more from a full tummy tuck. Best of luck! Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery

Gary M. Horndeski, MD · Answer

If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Rational945063,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because 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

Camille Cash, MD · Answer

From your photos it appears you are a good candidate for a full tummy tuck with liposuction for contouring.  This will remove excess fat and skin as well as correct abdominal wall laxity.  This should give you a flatter, tighter tummy and enhance the curves you are wanting.  See a board certified plastic surgeon for a consultation to learn more.

Lourdes Rodriguez, MD · Answer

Hello, thank you for your question and pictures.

In your case the best indication is a full tummy tuck to remove all the skin excess on your abdomen, this can be combined with liposuction of waist and back to achieve better results.

Make sure to approach to a certified surgeon to help you clear all your doubts.

Best wishes!

Best options for hourglass waist, tight skin, and less fat? (Photos)

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