Had several lipo on my stomach already. Are there any solutions out there for a smaller waistline? (Photo)

Hello Ocean Dolphin,
Thank you for your question regarding alternative solutions for achieving a flatter abdomen after undergoing three liposuction sessions.
You are correct in noting that the abdomen comprises various layers: small intestine, surrounding fat, muscle, and skin. Since you've already had fat removal through liposuction, other factors could contribute to abdominal distention. These include the small intestine, visceral fat around the intestine, the abdominal muscle, and the skin. However, based on your description, it seems the small intestine and skin are not the primary concerns.
Therefore, visceral fat and the abdominal muscle are the two likely contributors to your abdominal distention. Visceral fat, which surrounds your internal organs, can be effectively reduced through a ketogenic diet with intermittent fasting. Additionally, cutting out sugar and alcohol, combined with regular exercise, can significantly reduce visceral fat. Weight loss medications like Ozempic might also be considered under medical guidance.
As for the loose abdominal muscles, which are likely a major factor in your abdominal distention, a surgical approach to repair and tighten these muscles may be necessary. This typically involves a low abdominal incision through which the rectus muscles (the 'six-pack' muscles) are sutured or brought together (a process known as muscle plication). This procedure can significantly reduce the waistline, sometimes by 4 to 8 inches. In some cases, surgeons may also use mesh to flatten the abdomen further.
In summary, to address your abdominal distention post-liposuction, consider a combination of diet, exercise, and possibly a surgical procedure to repair the abdominal muscles. I recommend consulting with a board-certified plastic surgeon to explore these options further and to determine the best course of action based on your specific needs and medical history.
I hope this information provides clarity and assists you in finding an effective solution to your concern.
Sincerely,
Dr. Katzen

Dear OceanDolphin,
liposuction is the best procedure for body sculpting. You can also get fat transfer in order to make your waistline look smaller. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I would not recommend more liposuction. It appears that you have a round/protruding abdomen. Have you had children? The procedure to flatten your abdomen and narrow your waistline would be a tummy tuck. You probably have abdominal wall weakness, and possible a diastasis of your abdominal muscles. A tummy-tuck will improve this greatly. It will change the shape of your abdomen.

Liposuction can only remove fat that is subcutaneous, or in other words, located just below your skin. If you have fat around your internal organs (visceral) then this cannot be removed and may continue to make a negative impact on your waistline. In addition, abdominal muscle separation may also increase your waistline. You may want to consider seeing a board certified plastic surgeon for an inperson assessment to determine what can reduce the circumference of your waistline. Options may include a healthy diet/exercise regimen that can reduce visceral fat, and/or a tummy tuck that can repair separated abdominal muscles and eliminate loose skin if necessary.

Liposuction can address fat under the skin, but it cannot address when the ab muscles are pulled apart, when there is a lot of excess fat INSIDE the abdomen, or when you have a lot of excess, loose skin.
You should be evaluated in person by a surgeon, it looks like you might benefit from a tummy tuck with repair of your ab muscles and liposuction to your flanks. If the reason you have protrusion of your abdomen is due to fat INSIDE your abdomen then weight loss will make a huge difference!
Hope this helps!

Hello OceanDolphin!
There are two issues that come to mind from your photos...You could have intraabdominal fat that liposuction is unable to assist with. A registered dietitian could analyze your diet and help you to decrease your percent body fat which may help decrease your belly volume. Your body type may also not have a curvy waist, you may be more square. I would consult with a dietitian to help you achieve fitness which will help your waist, then return to plastic surgery for fine tuning as needed.

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.

Thank you for your question and photos. Based on these limited view photos, you do present with a protuberant abdomen. Most likely there's not enough fat in this area that will give you an improvement in this area with further liposuction. If you lay down flat on your back, and your abdomen "caves in", then you might be a candidate for a tummy tuck. If your abdomen stay convex, most likely indicates excess intraabdominal fat and an abdominoplasty will give you very limited improvement and a very long scar. This needs to be addressed by dieting and exercise, best under a physician's supervision. BTW, a smaller waist line cannot be achieved from liposuction of the abdomen and flanks in the supine position only. You seem to have lots of excess fat on your back and this needs to be liposuctioned from the back to give you a more defined waistline. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

You may be at the point where you shouid consider a tummy tuck. You will get a far greater improvement from a tummy tuck than liposuction

From the provided photo it appears that visceral fat is a contributing factor to your abdominal contour. This is the internal fat behind your muscle wall around your organs. It cannot be addressed through liposuction or a tummy tuck. Weight loss will help to improve it. A tummy tuck can remove excess fat and skin above the muscle wall as well as repair abdominal wall laxity.