Dear Shar, Thank you for your insightful question about enhancing your figure to achieve a more pronounced hourglass shape through cosmetic surgery. Your interest in both breast implants and modifications to your waistline demonstrates a desire for a harmonious and proportionate figure, which is a common goal among patients considering cosmetic enhancements. Liposuction is indeed a viable option for creating a smaller waistline and enhancing the hourglass figure you desire. While it is true that increasing the size of your breasts can visually reduce the waist's appearance, directly addressing the waist size through liposuction can physically contour and reduce the waist circumference. This procedure works by removing excess fat from targeted areas, which, in your case, would be the waist and possibly adjacent areas to accentuate the contrast between your waist and hips. Regarding your concern about there not being "much to remove" from your waist, a detailed consultation and examination would be necessary to determine the specific possibilities for your body. Even in cases where there is minimal fat, strategic removal can significantly impact the overall silhouette. Additionally, the recommendation to consider fat transfer to the hips can further enhance the hourglass effect by adding volume to the hips, thereby amplifying the waist-to-hip ratio. If liposuction alone does not meet your goals, or if your situation requires a different approach, other options such as abdominoplasty (tummy tuck) or body contouring procedures could be discussed. These alternatives can also sculpt the abdominal area and waistline, although they are typically more invasive than liposuction. Ultimately, the best approach will depend on your body's unique characteristics, your aesthetic goals, and a thorough evaluation by a qualified plastic surgeon. I encourage you to schedule a consultation with a board-certified plastic surgeon who can provide you with a personalized assessment and recommendations based on your specific desires and physical needs. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon