Excessive body fat appears for many in some very typical spots. Both men and women will experience undesired fullness around the waistline. From the stomach to the back that extra ‘tire’ can and will develop in many people. Despite diet and exercise, it is a hard area to lose. I have seen many very lean patients, who were near workout warriors, who could not get rid of it. (even though it was small) No amount of abdominal crunches or twists will make it go away.
While liposuction is well known to remove fat, how effectively it does so varies in different body regions. The main goals in liposuction is to remove as much fat as needed to make the desired contour change and to leave the overlying skin as smooth as possible. Irregularities, asymmetries and indentations are cosmetic complications of liposuction surgery. They can occur from over zealous fat removal in which the amount removed is uneven across the treated area. This can particularly occur around curved surfaces as the liposuction extraction cannulas are straight.
One of the most successful treatment areas in all of liposuction is that of the flanks or muffin tops. While this is a curved surface and liposuction fat removal is often uneven, the greatest amount removed is at the apex of the curve. (side of the waistline) While this would normally cause an undesired contour change, it actually is a potential contour benefit in the flanks. This causes a bowing in or indentation as the waistline wraps around into the back. In some patients this may even make for an hourglass silhouettefrom the side of the chest down to the hips in profile. As long as this indentation is not a narrow linear line, but a broader concavity, this is a desired flank liposuction result.
Flank or muffin top liposuction can be done alone which is usually reserved for fairly lean individuals who just have this one problem area. More times than not, however, it is part of a more global waistline reduction which includes the abdomen and the flanks together. Either way, the only postoperative care that is needed is to wear a wrap around Velcro binder. This circumferential compression not only provides support and comfort but also helps keep down swelling. It may have some minor shaping effect but that benefit is usually overstated.I advise my patients to wear the binder until it no longer seems beneficial for comfort. This can be anywhere from one to three weeks after surgery.
One method of flank liposuction is to use Smartlipo. While it is my personal choice at present, traditional liposuction in the flanks can work very well also. The key to a good result is to be aggressive and blend the fat removal both in back and into the side of the abdomen in the front. A straight line profile result is a good outcome for most patients but some more lean patients may be able to achieve a more tapered waistline.
Dr. Barry Eppley
Indianapolis, Indiana