Looking to reduce waist size. Best procedures for this? (Photos)

Question

I've been recently diagnosed with PCOS, which causes insulin resistance. This has caused me to gain weight, specifically in the waist, and has given me a terrible apple shape. I have been dieting and exercising and have lost 20 lbs thus far, and I plan to lose another 25-30 by next year. I want to get my waist shaped as a college graduation gift to myself next year. I was wondering what procedure/s would be best. I'd like to have a tiny but tighter tummy still, as shown in the photos.

Sean Younai, MD, FACS · Answer

many plus size women have extremely difficult time loosing weight due to multiple metabolic disorders. I have had nearly 20 years experience with large volume liposuction for plus size women. I have had many patients that went from a size 18 to a 10. If you have been able to maintain your weight and continue with a healthy lifestyle, large volume liposuction will change your body and life.

Farhad Rafizadeh, MD · Answer

Hi Ashley,
Let me first congratulate you on the high goals that you are setting for yourself. It requires a lot of self discipline and sacrifice. Regular excercise and eliminating carbohydrates will help your shape and your insulin resistance. The more you loose the better results you can get. After you have lost the weight, you need to consult with an experienced board certified plastic surgeon to evaluate the residual fatty tissue and the extent of skin looseness. One might be able to help you with liposuction alone or you might benefit from a combination of tummy tuck and liposuction to get the optimal results. I wish you the best and please keep at it.

Carolina Restrepo, MD · Answer

Thank you for your question. Based on your information and photos I think that you are a good candidate for tummy tuck and liposuction to the waist and back to optimize your overall shape.  Our central approach with these procedures is to provide a 360 degree improvement in order to get a beautiful flat abdomen, and to maximize feminine curves.  For the abdomen a tummy tuck will flatten the abdomen, cinch in the waist, and remove excess fat and skin from the lower abdomen.  Liposuction to the back and waist will give you a lean appearance and accentuate the hour glass figure. 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.

Michele A. Shermak, MD · Answer

Your surgical approach would depend on results after your weight comes off. Sometimes the skin and/or muscle is sagging and a tummy tuck may provide the best approach. More commonly you would likely do really well with Liposuction. You should consult with a board certified plastic surgeon for an evaluation. You can find one near you at plasticsurgery.org.

Robert M. Tornambe, MD · Answer

AshleyAnn.  Congratulations on the weight loss and it is obvious you are quite determined, which is great! Best to lose as much weight as possible and reach goal weight before liposuction.  This will optimize your results.  Be sure to consult with a board certified plastic surgeon. Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you will be a great candidate for a tummy tuck with liposuction after additional weight loss.  This can be done through a low incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.  I would recommend to be at your goal weight prior to surgery for the best results. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question and congrats on the weight loss and graduationI would suggest to maximize your weight loss it seems as though liposuction  and a tummy tuck at this point would probably not give you the desired look you are going for that being said continued weight loss would get you to a place that would set you up to get where you want to be, don't rush into surgery

Reza Momeni, MD, FACS · Answer

Best treatment would be to continue your weight loss until your BMI is in the 27-29 range at least, then you can consider plastic surgery treatments.

Erica Anderson, MD · Answer

Congratulations on your weight loss! Time will tell the best way to help you achieve your shape. If you lose another 25-30lbs, you will likely have lax abdominal skin and a tummy tuck may be warranted. Liposuction can be helpful though only addresses the top layer of fat. With PCOS, fat accumulates around your organs so continued weight loss is your best approach. Best wishes for continued success.

Michelle Copeland, MD, DMD · Answer

Liposuction works best on patients who are of relatively average
weight, but who need help with a problem area, or with shedding the ten pounds
they regain between diets. If you have good skin quality and minimal sagging,
you make an ideal candidate for liposuction.
People who have especially slack skin in their midsection need
more than what liposuction alone can offer. Typical candidates for a full tummy
tuck are women with drooping abdomens after pregnancy, women and men who've
lost a great deal of weight, menopausal women, or older people with loose skin
due to age. In the tummy tuck, the skin from the rib cage down to the pelvic
area is tightened, and the navel is moved up and secured in a new position.
For people who don’t want surgery CoolSculpt is now an option to
help reduce fat in selective areas. The CoolSculpting fat-freezing procedure is
the only FDA-cleared, non-surgical fat-reduction treatment that uses controlled
cooling to eliminate stubborn fat that resists all efforts through diet and
exercise. After CoolSculpting, treated fat cells that die are naturally
eliminated from the body. This process is not as rapid as invasive procedures,
such as liposuction. Typically, the most dramatic results are seen in 1-3
months after treatment. I suggest making an
appointment with a board certified plastic surgeon for consultation to discuss
your options.

Looking to reduce waist size. Best procedures for this? (Photos)

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