Options for Waistline Tightening and Contouring?

Help! I am approaching 50 and have lost my waist. I have always had a pretty flat stomach, now I have this waist roll and tummy pooch along with certain areas heading south. What can I do to tighten the skin in this area and get my waistline back?

Doctor Answers 4

Getting a Smaller Waistline

The permanent sutures that are used to flatten and tighten the abdominal wall are typically placed in the midline. The rectus abdominis muscles, prior to pregnancy, are lined up immediately side-by-side. Expansion of the abdominal wall during pregnancy allows the muscles to stretch apart, leaving a weak layer of fascia (connective tissue) spanning the gap between the two muscles - the medical term for which is diastasis. The midline tightening sutures correct the diastasis and bring the rectus muscles back into a 'side-by-side' configuration, flattening the abdominal wall in the process. Although this midline tightening dramatically enhances the abdominal profile, it often does adequately address the fact that pregnancy can also wreak havoc on the waist, turning what was formerly an 'hourglass' figure into something that is more cylindrical in shape. For several years now I have been using permanent 'internal corset' sutures, placed laterally in the abdominal wall, that draw the waist inward and restore some of the hourglass effect of abdominal concavity at the waistline in frontal view. The addition of these sutures to midline tightening, and in some cases in place of midline tightening, has allowed me to achieve even more impressive postoperative results.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Liposuction plus / minus a tummy tuck

Without seeing a picture of you I can't say for sure but at the very least you should explore having liposuction done. This is very effective in the flanks and generally the skin out there is thick and elastic and shrinks quite well. As far as the front of your abdomen goes, it depends on whether you have extra skin or not. If you do, you might need a tummy tuck to get the flattest tightest abdomen possible for your body. If the skin is not in excess and is of good elasticity, you might get by with just liposuction.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Tummy tuck and Liposuction will help

A combination of treatments will be needed. Excess skin will require a tummy tuck. Plication of the muscle during this procedure will accentuate your waist line as well.The excess fat in your flank area could be liposuctioned.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

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Check out your anatomy to determine liposuction, tummy tuck, muscle repair.

In any situation, analyzing your body and the best solution requires a review of your skeleton, muscle condition, fatty deposits, and skin elasticity.

The degree to which each of these factors are effected determines the best solution for you.

For example

  • Localized fat, but good skin, muscle, skeleton---> Liposuction
  • Bad muscle (diastasis) but good skin, fat, skeleton--> Endo muscle repair
  • Bad skin but good muscle, skin, skeleton---------> Skin only tummy tuck

Pregnancy can effect all 4 components requiring a full tummy tuck with liposuction

From the limited description, you give and with no idea of having been pregnant, I would assume localized fat with poor skin tone, which would could likely benefit from a mini/hybrid tummy tuck. However, there are alot of options and the best choice is to seek a consultation with a qualified physician.

Non-invasive skin tightening "lasers" or devices are of limited benefit in these conditions and I would generally avoid them.

I hope this helps

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

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.