Coveting a flat tummy? Find out what the top treatments for a tighter core are.

14 01 flat tummy stomach fat removal surgery tuck


From laser to ultrasound, there are a host of technologies today that can reduce fat non-surgically in the stomach region.

According to Dr. Cory S. Goldberg, MD, FRCSC, a Toronto cosmetic and plastic surgeon, ultrasound technologies (such as Liposonix, VelaShape and UltraShape) reduce fat by using focused ultrasound energy. “By concentrating the ultrasound, it is like focusing sunlight with a magnifying glass,” he says. “It passes through the skin and heats the fat to the point of breaking the cells.”

Other technologies, such as Zeltiq, Cool Shape and CoolSculpting, use cold stimulation. “This technique, known as cryolipolysis, depends on the unique characteristic of fat to waste away after being cooled to a certain point,” says Dr. Goldberg.

Toronto plastic surgeon Dr. Sean Rice, MD, M.S.c., FRCSC, also points out the use of radio frequency waves, such as with Viora, which uses a radio frequency wave known as CORE technology. “There are three separate radio frequency waves that correspond to how deep the energy can go into the skin/fat,” says Dr. Rice. “Therefore you can target different levels in order to tighten skin, melt fat or a combination of the two.”

BodyTite also uses a radio frequency to tighten skin and melt fat, while Venus Freeze uses a combination of magnetic and radio frequency waves to tighten skin and melt fat. Dr. Goldberg also notes the use of laser, as with Zerona, which uses laser light to cause fat
cells to rupture and die.

Downtime: When it comes to non-invasive technologies like these, patients can typically expect little to no pain, downtime or recovery, and normal activity can usually resume the day after the procedure. Some treatments such as Liposonix need pain medication at the time of treatment, says Dr. Goldberg, but none of the treatments needs any pain medication afterwards. Afterwards some people may take regular Tylenol for a couple of days only.

Treatment Protocol: Treatments are also generally scar-free. “However, depending on the type of energy used there is the chance of getting a burn,” notes Dr. Rice. Also, most of these treatments require multiple treatments.

Results: Too good to be true? That is up for debate. While these procedures are common for both men and women and can be used on most parts of the body, says Dr. Rice, most do require multiple treatments, and it can take up to a few months to see final results. As far as results go, “They are good for small areas of fat reduction and skin tightening,” says Dr. Rice, “but they will not replace liposuction for larger areas of fat removal or a tummy tuck for skin removal.”



Dr. Goldberg points out that the various types of liposuction are done through a few minimally invasive incisions, removing fat from the targeted areas— “essentially deflating those areas,” he says. “Some types of liposuction use lasers, ultrasound or radio-frequency [such as SmartLipo, SlimLipo and BodyTite] to stimulate the skin to tighten,” adds Dr. Goldberg. “Overall, these work well for younger individuals who have not had children or large weight changes [and] whose skin is reasonably tight.”

Downtime: Typically two to five days, with exercise resuming at two weeks. “Pain is generally minimal,” says Dr. Rice.

Scarring: Liposuction generally leaves a small scar hidden within natural body creases.

Full tummy tuck

Tummy tucks are called for when there is excess or loose skin to be removed or when there are signs of abdominal wall laxity. “The difference between choosing energy-assisted liposuction versus a tummy tuck depends on the quality of the skin and the underlying muscle,” says Dr. Rice. “If the muscle is loose and you perform liposuction only, you will not get a flat abdomen.”

Also known as abdominoplasty, the tummy tuck involves tightening the underlying abdominal muscles from just below the breasts to the pubic hair line and removing the skin from the pubic hair line to just above the umbilicus.

Downtime: It takes one to two weeks before returning to a desk job, with regular exercise and activities resuming after four to six weeks. (Patients need to wear a binder for six weeks, notes Dr. Rice.) The abdominal muscles will feel sore, and it will be uncomfortable getting in and out of a chair or bed during the first week, says Dr. Lawrence Tong, MD, FACS, FRCSC, of the Yorkville Institute of Plastic Surgery in Toronto, who uses a long-acting anesthetic at the time of surgery that lasts for 16 hours. “Patients stay overnight at our facility after a tummy tuck and can receive intravenous narcotics, as well. Afterward, oral narcotics are used when the patient is at home.” Some surgeons also use a portable pain pump —a small device that is worn in a hip sack, which delivers local anesthesia through tiny tubes into the tummy muscles for two days after surgery. “Most patients have stopped taking any pain medication by three days after surgery,” adds Dr. Goldberg.

Scarring: The scar resulting from tummy tucks can go from hip to hip and on the inner lip of the umbilicus, though the length depends on how much skin and fat are being removed, notes Dr. Goldberg. “Your surgeon should put this as low as possible so it is hidden within your underwear or bikini,” he adds. “A lot of how a scar forms is dependent on your surgeon’s technique in closing the surgical site. Best thing to do is look at before and after pictures to see what results the surgeon can achieve. A scar can only be judged one year after surgery, at which point it is finished healing.”

Mini tummy tuck

“The mini tummy tuck is usually employed in patients with minor amounts of excess skin or limited abdominal wall laxity,” says Dr. Tong, who adds that the process is similar to a full tummy tuck, but with less skin removal and muscle tightening in the lower half of the abdomen.

Dr. Goldberg cautions that the mini tummy tuck allows tightening of the skin and abdominal muscles below the belly button, but not above, whereas the full tummy tuck can remove more skin and tightens the skin and abdominal muscles from the ribs all the way down. “Out of 10 people who inquire about a mini tummy tuck in my practice, only one of those people are good candidates for that procedure,” says Dr. Goldberg, who adds, “The decision to have a mini tuck needs to be discussed carefully with your surgeon.”

Downtime: Dr. Tong says that downtime is typically 1.5 weeks, with similar symptoms to the full tummy tuck, but to a lesser degree.

Scarring: Since the procedure is less intensive than a full tummy tuck, the mini tummy tuck has a shorter incision, with a scar similar to that of a C-section.


So which is the procedure for you? That’s between you and your doctor. “Any procedure has certain risks and potential complications that should be reviewed by your surgeon at the time of your consultation,” says Dr. Tong.

“Choose a surgeon who is experienced in the procedure you wish to undertake,” adds Dr. Rice. “Ask your physician if he or she feels you are a good candidate for the procedure you are proposing, [and also if there is] an alternative and what can you expect as results from those alternatives. Patients should ask the practitioner if the procedure will match their expectations and how many treatments would be required,” says Dr. Rice.

Finally, remember that good health is key to any procedure. “A healthy lifestyle is important for any body contouring —surgical or non—,” says Dr. Goldberg.

Patients should be in good health both before and after surgery,” adds Dr. Rice, who says that a good diet and exercise regime is key to maintain results.