Waist Training, Liposuction or Tummy Tuck: What really works? (Part 1)


Patients are always asking me about the effectiveness of waist training; Jessica Alba, Brooke Burke and Khloe Kardasian swear by it, but recently after Kim Kardashian posted an Instragram photo showing herself all cinched up in a waist trainer it seems like the questions have really been flying. Does waist training really work? What can I do to narrow my waistline? Here are the facts.

Left: Classic tight laced corset style  Right: Malaysian Bengkung belly binding

Left: Classic tight laced corset style Right: Malaysian Bengkung belly binding

First of all waist training is really nothing new, it harkens back at least to the 1500s when corsets first came in vogue and maybe even further back in Asian and African traditions of pre-natal and post-natal belly binding.


Left: Exercise Waist Trainer (Spandex with hook-and-eye closure)  Right:  Corset Waist Trainer (Metal boning structure and lace up closure)

Left: Exercise Waist Trainer (Spandex with hook-and-eye closure) Right: Corset Waist Trainer (Metal boning structure and lace up closure)

Secondly, there is a difference between exercise waist training (the latest rage) and waist training. Exercise waist training involves wearing the equivalent of the Incredible Hulk of spandex around your waist during exercise. Actual waist training involves lacing yourself up in a corset with metal boning and laces for several hours daily and gradually reducing down to smaller corsets over time.

Waist Training

Illustration of the changes that occur to the internal organs during the corsetting process.

Illustration of the changes that occur to the internal organs during the corsetting process.

1.  If you stop your waist will pop (back out to its original size that is).

True waist training must be continued on a daily basis in order to maintain the result. People may begin to see “semi-permanent” changes with >4 and up to 23 hours of corseting 7 days a week. Several changes occur when you wear a corset, your internal organs are displaced lower down into your abdomen allowing tightening around the rib cage and the waistline. The ribs have some level of bendability, so with enough continuous pressure the ribs may begin to angle downward and inward and the bone and cartilage begin to remodel. However, as soon as corseting is stopped the tissues will all return to their normal pre-corseted shape. If you are only laced up for a few hours a day the changes will only last a few hours, if you are laced up for longer periods the changes may last for a few months. Bottom line is that the changes are not permanent.

 Exercise Waist Training

2.  There is no permanent waist reduction that occurs with wearing an exercise waist trainer during your workout.

The manufacturers of these products cite core compression, increased perspiration, and targeted fat burning over the abdomen thereby reducing the waistline. This practice does not increase fat loss over the abdomen. You will see some temporary reduction in inches due to compression and increased perspiration, quite simply water loss. The only way to burn fat is by increasing your aerobic exercise reducing calories and eating clean. This leads to fat loss all over your body. Remember, the formula to seeing changes in your body is 30% exercise and 70% diet.

3.  There are risks to exercise waist training. If the garment is worn too tightly it inhibits your ability to breathe at a time when your breathing rate is increased to satisfy your body’s need for increased oxygen. Oxygen is part of the fuel your muscle uses to create energy to function during a workout. Some women wear their waist trainer so tightly they actually faint during their work out due to lack of oxygen.

4.  Liposuction and Tummy Tuck procedures are surgical ways to achieve a whittled down waistline.

You may find that in spite of having a healthy diet, engaging in regular exercise, and maintaining a healthy body weight, you may still have love handles or some resistant fat and skin over the abdomen. This is true in particular for many women after child birth, as we discussed before in Erasing the Tiger Stripes: 3 Steps to Restoring Your Pre-baby Body there can be some post-pregnancy changes that the gym and certainly the exercise waist trainer cannot fix. Diastasis-RectiFor example, many women also develop a rectus diastasis after pregnancy. A rectus diastasis occurs when space develops between the two rectus abdominus muscles (six-pack muscles) as a result of being stretched during pregnancy causing the abdomen to protrude. Although core exercises will strengthen the muscle and improve the overall abdominal shape they cannot mend the gap; the abdomen will always be wider than before. Exercise waist training will certainly not improve this problem but liposuction or a tummy tuck can.

5.  Liposuction can achieve targeted fat reduction over the abdomen.

6.  During a tummy tuck we actually do tighten the muscles, creating an INTERNAL CORSET. If you have a rectus diastasis part of the tummy tuck procedure involves bringing the muscles back together thereby tightening the abdomen and narrowing the mid section.


Are you a candidate for Liposuction or a Tummy Tuck (Abdominoplasty)?

1.  Do you have a normal body weight?

A tummy tuck or liposuction does not replace weight loss. These procedures are for contouring and shaping. If you are more than 20% above your normal body weight or more than 50lbs overweight you are not a candidate for surgery. Remember removing the fat over the abdomen does not decrease the internal fat around your organs that is responsible for the increased risk of heart disease and diabetes.

2.  Is your weight stable?

You must have a healthy diet and regular exercise regimen to maintain a stable weight. If you are still gaining weight you need to get that under control first.

3.  Do you have extra skin and fat over your abdomen?

If the extra skin and tissue hangs over causing a fold on your abdomen you are likely a candidate for a tummy tuck. If you have extra fat but no extra skin, liposuction may be a better option.

4.  Have you finished having children?

You can still have liposuction if you are planning another pregnancy, but if you are interested in a tummy tuck you should wait until afterwards. Of course if you are a man or are using a surrogate you do not have any of these worries!

Don’t forget that you can eat your way right back out of your liposuction or tummy tuck. There is no trade off for a healthy diet and regular exercise. After we have done our part to give you a flat tight tummy you still have to do your part to maintain it. So protect your investment by watching what you eat and hitting the gym. Learn more about what to expect before, during and after liposuction or tummy tuck surgery.