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.


Erasing the Tiger Stripes: 4 Steps to Restoring Your Pre-baby Body.

Kerry Washington at her baby shower.

Kerry Washington at her baby shower.

You are a gladiator!! Like Kerry Washington (Miss Olivia Pope) and her other celebrity friends Megan Fox, Ciara, Kim Kardashian and of course her Royal Highness Duchess Kate (all new moms) you have been through the battle and come out victorious on the other side.  You have definitely earned each and every one of those “tiger stripes” required to carry a child through pregnancy and then nourish and care for them afterwards.  Although you would never change one moment of motherhood, many of you may be unhappy with some of the differences in your new post-baby body. You are not alone, many women experience deflation, sagging or enlargement of their previously perky breasts, and excess abdominal fat and skin over that previously flat abdomen.  2012 statistics from the American Society of Plastic Surgery (ASPS) show an increase in breast augmentation, tummy tucks, and liposuction among “mom-aged” women, with very high satisfaction rates for the results.

A few of my patients remarked on the frustration they feel about hours spent in the gym without being able to change those problem areas.

Her Royal Highness Duchess Kate and Kim Kardashian pre and post pregnancy.

Her Royal Highness Duchess Kate and Kim Kardashian pre and post pregnancy.

They wonder how Duchess Kate and Kim Kardashian are able to get back into shape so quickly.  Well first of all don’t beat yourself up.  Though there are many things that can be addressed with exercise and a good diet, not everything can be.  Also, do not forget that most celebrities have a big team behind them to help them to reach their goals.  So, how can you restore that firmer more sculpted shape that you had pre-pregnancy?  Here are some steps to reaching that goal.


1.  Avoid excessive weight gain during pregnancy.  If you are planning another pregnancy remember that “eating for two” does not mean eating twice as much.  Expert Dr. Kiwita Phillips, OB/Gyn at Morehouse School of Medicine explains that women only need an additional 300 calories (size of a small sandwich) a day to keep themselves and baby healthy during pregnancy.  She advises patients based upon the Institute of Medicine (IOM) guidelines.  According to the IOM most normal weight women should not gain more than 25lbs, women who are severely underweight may need to gain up to 40lbs, and obese women no more than 20lbs.  Dr. Phillips cautions that women who are morbidly obese (BMI < 40) may not need to gain any weight at all.

Institute of Medicine Weight Gain Recommendations for Pregnancy

Institute of Medicine Weight Gain Recommendations for Pregnancy

2.  Breast feed.  Some studies show that breastfeeding can help to reduce post-pregnancy weight as it burns 300-500cal a day.  Long term weight loss and reduction of fat in the mid-section has been noted for women who are able to breastfeed for greater than 6 months.

3.  Maintain a healthy diet and exercise.  This one is a no-brainer, you already know this.  Eating healthy is good for you and for the baby.  Lots of vegetables, fruits and water are important.  Stay away from processed foods.  There is no substitute for the health benefits of regular exercise; at least 150 minutes of moderate activity per week is recommended, check out Bikini Body Mommy for some great tips.


4. The Mommy Makeover.  The Mommy Makeover refers to a combination of plastic surgery procedures that are individualized and tailored to restore and rejuvenate the body after pregnancy.  For most women this includes a procedure on the breasts and the abdomen but can include other areas as well.  If you are planning additional pregnancies it is recommended that you wait before doing these procedures.

Breast Lift, Breast Augmentation & Breast Reduction

Women see a variety of breast changes after pregnancy.  For some women volume loss is the problem, their breasts have deflated after breastfeeding and they require a breast augmentation using implants.  The breast engorgement during breastfeeding can stretch the skin and leave the breasts sagging.  For women who experience this problem a breast lift may be an excellent solution.  For women for whom both volume loss and sagging are a concern a combination of breast lift and augmentation may be the best option.  Finally, some women experience significant breast enlargement after pregnancy and a breast reduction is a excellent way alleviate the neck, shoulder, back pain caused by the extra weight while simultaneously lifting the breasts.

Tummy Tuck & Liposuction

Many women are most frustrated by the excess fat and stretched out skin around their midsection.  It seems like all the hours spent at the gym trying a plethora of core exercises just doesn’t seem to touch this area.  Unfortunately there really are some changes post-pregnancy that the gym cannot fix.  In spite of attaining a healthy weight women may still notice some stubborn fat deposits on the lower abdomen and love handles.  Many women also develop a rectus diastasis after pregnancy.

Pregnancy causes the abdominal muscles to spread apart, this is called a rectus diastasis.

Pregnancy causes the abdominal muscles to spread apart, this is called a rectus diastasis.

A rectus diastasis occurs when connection between the two rectus abdominus muscles (six-pack muscles) actually stretches out causing the abdomen to protrude. Liposuction is a great option to target those areas of excess fat.  A tummy tuck tightens the stretched out abdominal wall internally bringing the rectus muscles back together, and removes the extra skin and fat hanging over the lower abdomen.


Every woman’s body is unique and has different needs.  Your plastic surgeon can help advise you about which options are best for you.  The good news is that you can have it all, all the joys of motherhood and the more sculpted shape that you had pre-pregnancy.