To get hourglass TT w/ Lipo, do you need abdomen and flanks lipo or do you need it elsewhere? Do all PS do hourglass? (Photo)

Liposuction allows you to have stubborn fat resistant to diet and exercise removed from unwanted areas and transferred to areas that can benefit from the added volume like the buttocks and hips. Liposuction of the abdomen, back and flanks results in a waist as small as possible.  Unfortunately, liposuction would debulk the fat but would not address any abdomen skin issues. The TT will be the only surgery to address skin laxity in the appropriate fashion.  
With a TT,  the stretchmarks to the level of the belly button are generally removed, sometimes more. The amount of skin removed in a TT depends upon the surgeon's technique and the patient's tissue characteristics. 
Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Dear samm8375,I guess it depends on surgeon's preferences. I usually combine tummy tuck and flank and abdomen liposuction to get an hourglass shape. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Thank you for your question. Tummy tuck, also know as abdominoplasty, is a procedure to remove excess skin and fat from the lower abdomen and to restore the weakened abdominal wall, giving a firmer and smoother appearance.  
We nearly always add liposuction to our tummy tucks to sculpt the body 360 degrees to achieve an hour glass figure. Most of the time liposuction is done to the waist and back.Tummy tuck is a very powerful technique in the right hands, and can have dramatic results if done correctly.  You definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety.  Don’t settle for less than a Board Certified Plastic Surgeon with specialized expertise in this procedure.

Thank you for reaching out. The results in the photo are unrealistic, you can definitely receive a great result from a TT and lipo. I typically take my patients back into the OR at around 6 months post op for lipo to contour the body, but you can not change the bodies shape that drastically. I would visit a few experienced board certified surgeons for in person consultations to discuss it more in detail. Best of luck. Dr. Kim

Thank you for reaching out, unfortunately, the photo you posted in my opinion would be an unrealistic end result expectation. Any and every experienced board certified surgeon is always aiming to contour the body and give you the best possible results. A TT is a great way to repair the muscles, remove excess skin and contour the body, I would just make sure you are not expecting the above results. Best of luck on your upcoming procedure! Dr. Kachenmeister

Most plastic surgeons do judicious amounts of lipo, with an emphasis on the love handle/flank area, in order to optimize the shape of the waist and abdomen when doing a tummy tuck. This is sometimes especially important for heavier patients who may have an extra roll or two between the lower abdominal love handle and the side of the ribs. The degree to which this desired "hourglass" can be achieved depends on your skin quality in that mid-flank area, how deep the creases are between the rolls of fat, how aggressive the lipo is, and how easily your abdominal wall plication (muscle tightening) is performed. Even with all that, the hourglass result is rarely as picture perfect as this photo, which appears to have some creative "cheats" as Dr. Cassileth has pointed out. I see a lot of these social media results for BBL, tummy tuck, lipo and other procedures where the contours appear altered in Photoshop or at least the position and lighting in the after photo are so different that they can't help but overaccentuate the result in the waist. Some photos of hourglass results and heart-shaped "booties" out there are actually fraudulent so be careful. Having said that, yes, most plastic surgeons experienced in body contouring are able to significantly improve the waist and midsection for a more shapely, curvaceous torso after surgery.

Hourglass tummy tuck is just aggressive liposuction around the waist, combined with rectus diastasis repair. I need to lodge a big complaint here about these bad to the point of unethical before and after photos... the ones you show is a very obvious "cheat" where the post-operative photo have the patient with her arms in the air. The surgeon must think us pretty dumb to fall for that... this will make you look like an hourglass with no surgery at all! Also look for obvious lighting changes... this one has a cheat on that too with a downward light in the beginning and a flat light in the post-op. And another, THIRD cheat, the angle shot on the post-op is from a lower point of view (less foreshortening so it looks thinner) and includes more of the body (so it looks smaller next to the pre-op). Yuck.

Great question.  To get an hour glass figure several things can and should be done depending on your body needs:1) Strong muscle tightening 2) Liposuction of the flanks with or without liposuction of the lower back3) Designing the tummy tuck to have the upper skin be pulled toward the midlineJust look at the before and after photos of the plastic surgeons you are considering.  The photos should show you how much of an hour glass figure they usually get with their tummy tucks.All the best,Dr. Remus Repta