Your Questions

Q: Dr. Eppley, I have had several children and am wanting to get my stomach back in shape. I am only 26 years old and I don’t want to live the rest of my life with this stomach. I am too young for that! My question is what will happen to my pubic area after a tummy tuck. I noticed that it got bigger after having children and I would like to see that area flatter as well. Will it be taken care of if I get a tummy tuck? Also I have love handles that I would like to get rid of as well. Will a tummy tuck get rid of those as well?

A: A tummy tuck will only solve the problems that lie within its zone of tissue excision. When looking at the markings of a tummy tuck, you will see that the love handles and the pubic area lies outside the excision zone. However, the addition of flank liposuction is a part of most tummy tucks with the recognition that the goal is an extended waistline reshaping that wraps around to the back. Pubic or mons reduction, if needed, can be incorporated as part of the tummy tuck procedure whether it is reduced with liposuction or it is lifted as part of the tummy tuck design. You can see in planning a tummy tuck that the entire area must be taken into consideration to get the best overall result.

Dr. Barry Eppley

Indianapolis, Indiana

Muffins and their tops are very appealing in this colder weather. On a brisk wintry day the thought of warm coffee and a muffin is hard to resist. But indulging in too many will likely give one a permanent addition of their own. While they are cute and crispy on an actual muffin,  they are less than flattering on one’s body. Both men and women grapple with the muffin top fat deformity. Most know this name as it provides a clear picture of unsightly rolls of fat that pop out and over one’s waistline.  Muffin tops seem to be a feminine description, in men they are better known as love handles.

Why fat deposits want to settle in this area is not known. Certainly genetics plays a major role in where and how the body distributes its fat. While diet and exercise helps control how much fat is deposited, such efforts don’t always prevent it from accumulating on the waistline. I have seen many fit patients, who exercise regularly and are weight conscious, but still developed a bit of a muffin top. This is especially true as one ages where these stubborn pockets of fat develop even if one is fairly weight appropriate for their height. The fashion world has contributed to this problem in women where waistbands are becoming lower and tighter, exposing and emphasizing these fat bulges.

The muffin top has always been an ideal area to treat with liposuction. It is considered ideal because of two important treatment considerations. It can be maximally reduced with liposuction even though it is a curved surface that is being treated. Aggressive liposuction can be safely done because if the area becomes over-resected, no aesthetic harm is done. There is probably no such thing as a waistline that tapers in too much. Fat in the muffin top or love handle comes out very easily with liposuction. Secondly, it is not a big area to treat so fat removal is fairly quick and recovery is relatively easy. One may only need a few days off work and the wearing of a compression garment for a week or two to get back to a normal lifestyle.

As liposuction as evolved, many patients wonder what is the best method and does one work better for the muffin top problem. The technology has evolved in liposuction with different ways to help break and loosen the fat for it then to be suctioned out. My current preference is the use of the laser probe. Known by the brand name of Smartlipo, laser liposuction helps heat and melt the fat. This not only does a better job of destroying the fat in the too fatty araes, but contributes to less pain and bruising afterwards.

While muffin tops can appear in isolation, most of time they are part of a more global waistline problem. Muffin top reduction is often part of abdominal and hip liposuction as well as tummy tuck or abdominoplasty surgery. For most patients, the muffin top is just part of a near 360 degree waistline fullness. But whether they appear alone as side bulges or just part of the ‘spare tire’, today’s liposuction techniques can successfully rid one of these less than flattering protrusions…in just slightly more time than it takes to drink that cup of coffee and finish off that muffin.

Dr. Barry Eppley

Indianapolis, Indiana