I want a flat stomach and snatched waist and I just don't know what to do? (Photo)

Question

I have had both a tummy tuck consult and a liposuction consult. I was told the tummy tuck was not a good idea because there wasn't enough skin to pull down, and I would end up with a scar where my belly button was. As for liposuction, the doctor said she wouldn't advise it because there wasn't enough squishy there to suck out. She said she could do my flanks, but wasn't certain it would provide the result I wanted. 5'7 128 lbs. 56. Morpheus8 on my stomach helped a little. Coolsculpt not great

Gary M. Horndeski, MD · Answer

At 5'7 and 128 lbs, your BMI is slightly over 20, which puts you in a lower range of normal. As the previous doctors have stated, you do not have much fat to be sucked out and you may not have enough skin. If you are not planning future pregnancies, you can undergo 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. This can be done through a lower transverse incision. The skin will not necessarily by resected but would hide the scar from the tummy tuck.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding your liposuction consultation and for sharing your medical history and pictures. Based on the details and photos you’ve provided, it’s understandable why your previous consultations may have been hesitant to recommend certain procedures, but I believe there are options to help you achieve your desired flat stomach and snatched waist.

Regarding a tummy tuck, I agree with your surgeon that it may not be the best option for you if there isn’t enough loose skin to justify the procedure. A tummy tuck typically requires sufficient excess skin to pull down and recontour the abdomen. Without that, you could be left with an unnecessary vertical scar near your belly button, which may not provide the aesthetic improvement you are seeking.

As for liposuction, while standard liposuction may not have been recommended due to limited fat deposits, VASER High-Definition Liposuction could be an excellent option. This advanced technique allows for precise fat removal and muscle definition, even in leaner patients like yourself. With VASER, fat is selectively emulsified and removed, enabling the surgeon to sculpt the abdomen and waistline for a more athletic, contoured look. It can also target your flanks to enhance the waistline and create a more defined silhouette.

Your experience with Morpheus8 and CoolSculpting likely helped with some minor tightening or fat reduction but didn’t achieve the dramatic results you’re looking for. VASER liposuction provides more impactful and noticeable outcomes by addressing both fat removal and muscle definition in one procedure.

I recommend consulting with a board-certified plastic surgeon who specializes in VASER High-Definition Liposuction. This approach aligns well with your goals and can help you achieve the flat stomach and snatched waist you desire.

Good luck, and I hope this helps address your concerns regarding your options!

Sincerely,
Dr. Katzen

Finny George, MD · Answer

Hi, thank you for sharing your question. Based on the photos alone, you seem to be a good candidate for liposuction. There may be an element of skin laxity or abdominal wall laxity which can also be corrected without a full tummy tuck.

Chet Mays, MD · Answer

Thank you for your inquiry!  An in-person consultation would allow me to determine what would be your best option.  We love to meet with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgery to help you reach your goals.

Arif Eroglu, MD · Answer

Thank you for your question. You are not a suitable patient for a Full Tummy Tuck procedure in my opinion. Either Abdominal Vaser Liposuction and Mini Tummy Tuck; or Vaser Liposuction and Renuvion J plasma can be performed (for tightening purposes). Both your abdominal skin tightens and it is possible to make abdominal shaping by removing excess fat. 
Kind Regards

Ricardo L. Rodriguez, MD · Answer

hello,
Based on the photos it does seem like you don't need a Tummy Tuck. But only an examination could say for sure. With the question of Lipo, the photos are highly cropped so it is hard to determine because I can not see your entire torso.

However, I have performed Lipo on patients who way less that 128 pounds.  I use very thin cannulas  (3mm) and extract fat from fine areas.  I sometimes use an Ultrasound over the abdomen to determine the amount of fat in the abdomen.  In some cases, there really is such little fat to remove that I suggest alternate areas such as the flanks, instead of the abdomen. But generally speaking, in most cases, thin cannulas can do more than fatter cannulas.

Hope this helps and thank you for your question.

Ricardo L Rodriguez MD
Board Certified Plastic Surgeon
Baltimore, Maryland

Donald Groves, MD · Answer

Hello and thank you for your question. From the pictures you have provided, it is incredibly difficult to assess anything. From the little I can see, it looks like you have a minimal amount of excess subcutaneous fat and skin present mainly in your lower and mid abdomen centrally. I am unable to assess your flanks. Based on all this, and your description, you would possibly benefit more from a traditional abdominoplasty (tummy tuck) to help improve your abdominal/trunk contour. 
There is always a possibility you might have a residual vertical scar (from the cutout of your current belly button) if it is determined in the surgery that there is not enough tissue to resect. This may or may not be connected to the main horizontal tummy tuck scar. Of course, we surgeons always try to remove enough skin in the operating room to prevent this vertical scar, if it is safe to do so. Some surgeons pull things tighter than others, but the downside of pulling things too tight and resecting too much skin during this procedure is there can be too much tension on the horizontal wound- meaning they might not be able to get things closed in the operating room, or if they do, the wound will be under too much tension which can significantly increase the risk of wound healing complications (wound breakdown, dehiscence, infection, widened or unattractive scars). Weighing these potential risks against the risk of a small vertical scar which almost always heals uneventfully and is minimally noticeable, I'm sure you'd agree that the small vertical scar is worth it. Regarding the transverse lower abdominal scar, it should be well hidden within your underwear, and if you adhere to proper scar care and sun avoidance after surgery, it (and any potential vertical scar) should eventually heal to be minimally noticeable. And depending on how close the vertical scar is to the horizontal scar, it can always be removed at a later time (6-12 months later) in the office under local, if this is truly a concern.
If your issue is predominantly skin excess, as you mentioned, the less invasive options are not going to be much help (or any help) for your current concerns.
Liposuction is a great adjunct which could possibly provide some additional benefit, particularly to the contour of your flanks (if indicated), and can be done at the same time as your tummy tuck procedure for the best possible single operation results.
With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from these very limited photos and the description provided. It sounds like you have already seen multiple plastic surgeons for evaluation, but you can always seek additional opinions if you want. Ultimately you should choose a surgeon who you trust, feel comfortable with, and who you feel can deliver the best results that align with your individual goals. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Daniel Barrett, MD · Answer

Dear weekers,
it is hard to tell for sure without an examination. 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

Leila Kasrai, MD, FRCSC · Answer

Based on your photos, it doesn’t appear that you have much loose skin. Although it doesn’t appear so, an in-person assessment would determine whether you have abdominal muscle separation. If there is, then a tummy tuck could repair the separation, which could help flatten your midsection. If there isn’t and you don’t have any loose skin, then a tummy tuck would not be suitable for you. Liposuction can remove fat located under your skin, but since you’ve already been told that there wasn’t enough, then it may be possible that excess visceral fat is the cause of your protruding midsection. This can only be resolved with a healthy diet and exercise.

Yily De Los Santos, MD · Answer

Thank you for your question and pictures. You are eligible for both procedures, liposuction or Tummy Tuck, the choice depends on what's your goal. With a liposuction, you might have some excess skin, in your case I suggest adding JPlasma to the procedure. And with a Tummy Tuck you'll have a much smaller waist and flatter abs, but you'll have a Tummy Tuck scar which goes from hip to hip bone.

I suggest thinking of the pros and cons and deciding on what's your priority.

I suggest thinking of the pros and cons and deciding on what's your priority.

George Marosan, MD · Answer

Thank you for your question and photos. The posted photos are not helpful to give you an answer based on them alone (close up and limited view). Your BMI is 20. Based on this, you are a great candidate for VASER Hi Def Lipo 360 degrees. Anything less, will not give you a "flat stomach and snatched waist". Skin laxity can only be assessed via an in person consultation/evaluation. It is possible that you need subdermal skin tightening (I use the Renuvion) at the time of the liposuction. As a Total Definer surgeon, I use advanced body sculpting techniques as opposed to fat reduction only which is practiced by the majority of plastic surgeons. Morpheus does not have deep penetration and Coolsculpting causes mass fat necrosis, unevenness or occasionally paroxysmal adipose hyperplasia (PAH). I operate on a lot of patients who had disappointing results from Coolsculpting and in my experience, these patients are very difficult to sculpt due to the intense internal scaring created by the device. I would advise against further Coolsculpting treatments.
See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation. Good luck.

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