What is the best procedure for me to get in order to obtain a flat stomach? (photo)

What kind of surgery would I need to get? Liposuction or full abdominoplasty? The doctor I have a consultation with said I am a good candidate but should I lose more weight before? I am 5'6 190 pounds and have been strength training along with high intensity cardio. Carrying fat in the abdominal area is genetic for me. I also had gynecomastia surgery two years ago.

Doctor Answers 14

Best Result For A Flat Stomach

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By your comments and previous gynecomastia, it appears you are whole heartedly committed to your
health and personal goals.  The high intensity cardio and strength training are excellent and should become
a way of life.  By the pictures you have shared, you are a good candidate for abdominoplasty with liposuctioning
of the flank areas to give you your acquired goal.  I like my patients to be close to their ideal weight or within
40 lbs.  After a tummy tuck, most of my patients loose the remaining weight, stating that having the
tight abdomen seemed to give them a feeling of fullness.  Whether this is real or subconscious, it works!!

Dallas Plastic Surgeon

Abdominal contour enhancement

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The Abdominoplasty  takes care of both the extra skin and also the muscle laxity but the procedure does not address the intra abdominal fat accumulation. That is addressed by weight loss (minimizing certain types of carbs as intake and maximizing cardio as exercise). Weight lifting is anaerobic and therefore doesn't really help with weight loss. Also, When you lay on your back, relaxing, your abdomen should be either flat or concave. It should not be convex ( rising upwards).

What's best?

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There is no substitute for a personal consultation with a board certified plastic surgeon.  Much will depend on whether you are carrying most of the fullness within the abdomen or beneath the skin.  Fat that is located deeper in the abdomen around the intestines is not accessible to plastic surgery and must be addressed with weight loss.  More superficial fat can be removed with both liposuction and a tummy tuck.  The decision between these two procedures will depend on the laxity of your skin and the need for tightening of your abdominal muscles.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

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Best Procedures

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Thanks so much for sharing your pictures and for your questions. Although a face to face consultation is needed, I would say that the best procedure for you will be a tummy tuck plus liposuction. You will certainly need to keep up the healthy habits before and after your procedure. It is always recommended in order to achieve the best outcome, to be at your ideal weight prior your surgery but sometimes it is too hard to get there. Don't give up! We are here to help, Regards and Good luck.

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Lipo vs. tummy tuck vs. weight loss

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Hi.  This is one of those situations where physical examination in person is the key.  I need to sort out whether your fat is intra-abdominal or subcutaneous, and exactly how much skin laxity you have.  That would best help determine the answer.  

Looking at your photos, you might benefit from a combination procedure - liposuction initially, then a tummy tuck (or mini TT) if the skin doesn't shrink up adequately after 6+ months.

Of course, carry on with your weight loss and training efforts.

Pinchable fat or visceral fat?

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Judging by your photos, you would probably benefit more from a tummy tuck since it appears you may have loose skin, which would only get worse if liposuction were performed alone. However, it is difficult to determine from your photos if there is more "pinchable" fat (subcutaneous) than visceral fat. If your stomach is firm and you can't really pinch much with your fingers except for skin, then you have fat that is located deeper and that can only be addressed with a healthy diet and exercise regimen. 

Tummy Tuck or Liposuction?

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Thank you for providing photos with your question. Based on your pictures, you appear to be a good candidate for liposuction. You do not have to be at your ideal weight on your surgery day. It is best to be at a healthy, stable weight that is easy for you to maintain. If there is excess intra abdominal fat (fat below the muscle), you will not reach your goal of a flat stomach. That can only be lost through diet and exercise. So keep up the healthy habits and you will reach your desired outcome!

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Diet, Exercise and Liposuction

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Diet! I'm sorry but there is no we are getting around it. Diet and exercise are the mainstay for physical health and fitness as well as a lean and attractive abdomen. From the photos that I can see start with that.. Once you have done all that you can on your own then plastic surgery may be an option. Lipo suction will help flatten the stomach if the majority of your fat is above the abdominal wall. Lipo suction will do nothing for the fat that lines the outside of your intestines (that's diet).

Remember however that Lipo suction alone does not address skin laxity. When fat is removed the skin will contract only slightly and this becomes even more problem after the age of 40. When your surgeon feels that your skin laxity will be excessive he may recommend abdominoplasty (tummy tuck) to handle the anticipated redundant skin. That currently is the gold standard for excessive skin laxity around the mid section. However for moderate skin laxity one can now consider laser assisted liposuction. Smart Lipo (Cynosure trademark) uses a laser underneath the skin to generate up to 3 times more contracture of the skin that occurs after standard liposuction.

Peter H. Grossman, MD, FACS
Los Angeles Plastic Surgeon

Flatter stomach

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It appears that you likely have fat both above and below the muscles of the abdomen. The fat above the muscle can be removed with liposuction but if you have a significant amount of intra-abdominal fat, the fat below the muscle, the stomach will not be flat until you lose that. The only way to lose that is diet and exercise.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Tummy tuck

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Hello, thank you for your question and the pics. It appears you are already a good candidate for both tummy tuck and liposuction. The tummy tuck will give you the flat abdomen you want and liposuction will get rid of the love handles on the side, giving you the aesthetic male body wide at the shoulders and thin at the hips. It is recommended you loose all the weight and stabilize at this weight before the procedure, so you'll be molded at your desired weight, as loosing a lot of weight after the procedure will damage the result. Good luck with your surgery

Jose Leon, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 82 reviews

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.