Liposuction on Stomach: Are Flanks Included in Abdominal Liposuction?

Yes, flanks are often included.

The “stomach” is one of the common topics of confusion during the very first trips to Lin Health Europe Clinic specialists. For example, when a patient says, “I want to get rid of this,” pointing at the belly, the gesture is usually one hand coming from one side of the body to the other, like passing down the belly button and wrapping the sides. So to the patient, the whole torso looks like one problem area. But in the precise medical language of Cosmetic Surgery, the “abdomen” and the “flanks” (love handles) are two separate anatomical parts with different surgical codes and pricing.

Such a separation causes the main question: If I pay for my stomach liposuction, will my sides be done for free? The long answer is generally no. Normal stomach liposuction is really limited to the anterior (front) side of the trunk, basically the area of the upper and lower belly fat pads that lie between the ribs and the pubic bone. The flanks, which run from the side of the rib cage down to the hip bone and further wrap around the back, are considered a separate cosmetic unit. It is therefore very important to comprehend the line dividing these two parts, as one can get the disappointing results of an unbalanced, “boxy” figure, not the hourglass one that is usually the patient’s wish, if they get one without the other.

The Anatomical Boundary: Where the Stomach Ends

The abdomen to a surgeon is anatomic region strictly determined by reference points: it extends from the inframammary fold, the lower edge of the breast, to the inguinal ligament or the groin area, and to the sides it is limited by the anterior axillary line, the imaginary line drawn vertically from the front edge of the armpit. The surgeon reaches a practically definite surgical border this way. Performing a surgery called “abdominal lipo” and without patient consent or prior discussion, a surgeon cannot cross this threshold since one will actually be performing the surgery on an entirely different body part. Hence, the reason for cheap quotes in “stomach lipo” which in reality means a session with only the anterior body panel considered.

Besides that, the nature of fat in the two parts can be very different as well. Generally, fat in the middle of the belly is a mixture of subcutaneous, which is pinchable, and visceral, which is internal, though it is usually softer. However, the flank’s fat is almost all subcutaneous but is also more fibrous and denser. Because of such tissue density variation, the surgeon frequently has to change energy level settings—e.g., use higher ultrasonic power on the tough and resistant flank fat and lower levels for the delicate layer of abdominal tissue—in order to get nice even smooth removal.

The Risk of Disharmony: The “Muffin Top” Effect

Should the patient be obsessed with the stomach and want to see it flat without the temptation of getting rid of the side flanks at the same time, the final aesthetic outcome might be shocking. Flattening the belly’s anterior part results in the untreated sides looking relatively bigger although their actual size is unchanged, i.e. they haven’t increased in volume. It is a trick of the eyes brought about by the contour’s sudden change. The person appears perfect from the front, looking in the mirror but when one gets the profile or the 45-degree view, the love handle protrusion resulting in them looking very “boxy” is obvious.

The above-mentioned inconsistency is often among the “must-have” terms in this industry. Think about the “muffin top” or the “boxy” shape of a torso. When the sides are not contoured in a way as to match the flatness of the front stomach, the waist does not get “snatched” or narrowed; rather, it is just the front portion that is made smooth. This leaves the patient dissatisfied despite a technically successful stomach reduction, because the overall shape remains rectangular. Only when the transition from the belly to the back is congruent, without any stairs or bulges visible from where the cannula was pulled out, can the result be considered great and transformational.

The Gold Standard: Lipo 360

This collection of individual disjointed features that doesn’t really look nice can be quite simply avoided. Hence the development of modern body contouring which has centered around Lipo 360. This refers to neither a particular device nor a brand, but the complete circumferential method. In simple terms, instead of seeing the body as made up of separate 2D planes (front vs. back), the surgeon views the whole torso as one continuous 3D cylinder. The contour is thus so natural that one cannot really tell where the waist ends and the hips or the belly begins when liposuction is done in the upper and lower parts of the abdomen, the flanks as well as the lower back at the same time.

By following this plan, the doctor is able to inwardly curve the waist quite significantly, thus increasing the ratio of hips to waist in females or giving the V-shape to the trunk of a male. Such a feat of a body sculptor is simply not possible when only the stomach is worked on. Lipo 360 happens to be good both for the patient and the surgeon, who can even out the edges and ensure no “skip, spots” of the leftover fat. That way, the operation is no longer mere “debulking” (volume reduction) but actual “body sculpting,” when the patient’s topographical muscular anatomy is unveiled and an athletic, fluid figure is created.

Skin Tightening Differences

Bundling of these three or two areas together might have another explanation – skin quality and elasticity differences. Normally, the skin on the anterior abdomen becomes very loose, Figure 1: Midline abdominal skin laxity with rectus diastasis especially in women after pregnancy or those who have had very significant weight fluctuations; therefore, the tightening process usually requires us to resort to the latest technologies such as J-Plasma (Renuvion) in order to get the skin to rally hard against the muscle layer. Without skin tightening, it is possible that the front after removal of an adequate amount of fat from this area, skin may become too loose and wrinkled, and may even hang over the belt line.

On the other hand, the skin of the flanks is naturally thicker and more firmly attached to the underlying fascia. It is therefore less likely to sag, but the dense fibrous fat here requires the use of high-energy ultrasound (like VASER) to break down smoothly without causing any skin irregularities. A single surgery for both areas will allow the surgeon to merge these two different methods—on the front, the retraction energy is at its maximum, while on the sides it is the emulsification energy—that the final skin texture becomes identical all around the torso.

Abdominal Lipo in Turkey

It is not our habit at Lin Health Europe Clinic to do isolated abdominal liposuction unless the patient already has a very low body fat level and a particular localized bulge. For the overwhelming majority of our international patients who come to Turkey for a radical change, we make a complete 360-degree approach recommendation. It’s like viewing the midsection as a great piece of artwork, demanding that the sculpting is done from all sides. Our experience shows that “piecemeal” procedures often result in revision requests later on.

Typically, we make available “packages” that take in the abdomen, the flanks, and the lower back altogether, thereby ensuring that the figure goes right through from the front to the back when a person wears a slim dress or swimming shorts. To us, the holistic way is the best approach as we recognize that the most natural-looking results are not solely dependent on the amount of reduction but on the harmony achieved through balance. When the whole trunk is dealt with as one unit, we are able to produce a very high definition, snatched waistline which is the hallmark of present-day aesthetic standards and not simply a flattened stomach on a broad ​‍​‌‍​‍‌​‍​‌‍​‍‌torso.

Frequently Asked Questions About Stomach and Flank Liposuction