What is the best procedure to get a smooth stomach? (Photo)

I am a 59 year old women, Very fit and use my abdomen muscle at an advanced level. I have had liposuction 3 times and still not able to achieve smoothness- What can I expect (what it would look like) if I did have the tummy tuck. Will it be smooth or still lumpy? Do I need a fat transfer, tummy tuck or a mini tuck (just have my skin pulled down)? What are the best results of what I can expect? Any suggestions on a great doctor to see for optimal results?

Doctor Answers 8

Over done Liposuction

Overly aggressive liposuction or repeated liposuction performed when abdominoplasty is indicated, may lead to  dimples and contour irreguarities that require multiple techniques to correct. In these photos, there is evidence that such has taken place. 

Correction takes into consideration the finding that this patient has a high riding belly button and the skin could be floated downward without a scar around the belly button. Also, the indentations reflect not  only absence of fat underneath, but also areas of tethering of the soft tissue to the underling structures. So the liposuction cannula should be used to mobilize the flap and to soften the indentions, but no fat is originally removed. Rather it is kept and allow to shift and to smoothen as one floated the skin downward. ( It is difficult to reliably inset fat when the flap is being mobilized at the same time). 

BTW, I do not like reverse abdominoplasties because they frequently produce an unsightly webbing between the breasts. 

SMOOTH STOMACH

By looking at your photos, seems that you had lose skin from the previous liposuctions and some scar tissue under the skin. The problem is your skin tone is not very good and even with a tummy tuck the skin will get very smooth. Most of the lose skin is on the upper abdomen, and you do not have that much extra skin on the lower abdomen for a tummy tuck. You may be a better candidate for a reverse tummy tuck, that can lift the lose skin under the breast, where is the most of extra skin. You will need a consultation in person with a Board Certified Plastic Surgeon for an evaluation.

Give me a smooth tummy

Hello and thank you for your question . I believe that the only way to get as smooth a tummy as possible is to have a full tummy tuck .  Suggest consulting with a board certified ps with extensive experience in performing tummy tucks and revisional surgery . 

Peter Fisher M.D 

Peter Fisher, MD
San Antonio Plastic Surgeon
4.9 out of 5 stars 49 reviews

What is the best procedure to get a smooth stomach after three liposuction procedures?

Unfortunately your liposuction is left you with significant irregularities and indentations.  The only manner to improve this is to consider a full tummy tuck.  After the tummy tuck you may wish to undergo fat grafting if the indentations are still noticeable and bothersome to you.  I would hope to achieve a dramatic improvement but would counsel you that perfection is unlikely.  Best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

What is the best procedure to get a smooth stomach?

Thank you for your question and photos. Based on your photos, your liposuction left you with deep unnatural grooves. This is a combination of loose skin and poor surgical technique. Unfortunately, this does leave lots of internal scarring. Your best option for a smoother and flatter abdomen is a full tummy tuck with wide scar release, possible further liposuction +/- fat grafting. This is very difficult and honestly, your abdomen will never be perfectly smooth. See a board certified plastic surgeon who has experience in these secondary operations from previous poor outcomes. Good luck.

What is the best procedure to get a smooth stomach?

Hello and thank you for sharing your questions and photos on RealSelf.com.

It appears that a complete tummy tuck including tightening of the rectus muscles will give you a much flatter and smoother tummy.  A mini tuck will not flatten as well.  Adding some fat injections at the time of the tummy tuck is also an option.  The problem I see is that you may have some residual areas of indentations from the liposuction procedures you had in the past.  These would be treated after the tummy tuck with fat injections if they bothered you.

A complete tummy tuck provides dramatic results with scars hidden in the bikini line.  They fade within one to two years on average.  The recovery is a bit prolonged but pain manageable especially if the surgeon uses a long acting anesthetic called Exparel.

My advice is to get several recommendations from board-certified plastic surgeons who are experienced with these types of procedures.

Good luck to you.

Dr Spies


Robert J. Spies, MD
Paradise Valley Plastic Surgeon
5.0 out of 5 stars 80 reviews

What do I need to do to have a flat stomach?

Thanks so much for your question.  Based on your photos you are a candidate for a full tummy tuck. It's difficult to see if you would be completely smooth following a tummy tuck just based on your photos. I think there is a good chance that's all you would need. However, there is always the chance that your surgeon would have to add a small amount of fat to dented areas during the procedure.  I do not believe anything short of a full tummy tuck would give you your desired results. Hope this helps. Have a nice holiday. 

Shaun Parson, MD
Phoenix Plastic Surgeon
4.8 out of 5 stars 42 reviews

What is the best procedure to get a smooth stomach? (Photo)

You look like a great candidate for a Tummy Tuck. 


  there are different types of tummy tucks which one is right for me and how are they different from the other? There is a mini tummy tuck, tummy tuck and a vertical abdominoplasty. The appropriate procedure depends the amount and location of the excess skin. That's what your plastic surgeon will have to determine after the actual physical exam.


   The recommended BMI is less than 30. This is the recommendation of the American society of plastic surgery. The reason simply, is increased chance of complications. These include but limited to, pulmonary embolus, deep venous thrombosis, delayed wound healing and increase infection rate.


Choose a board certified plastic surgeon who has done a ton of Tummy Tuck and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.


Many surgeons, including myself, offer online virtual consultations where you send us your photos and we can estimate the cost. I, like many surgeons, also offer free consultations so that you can be examined and given the most accurate quote possible. Please be mindful that the in person physical exam is the most important and could potentially alter your treatment plan.




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.