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Ask A Plastic Surgeon: Hourglass Tummy Tuck

Written by Cameron Erickson, MD, Board Certified Plastic Surgeon on February 21, 2023 No Comments

hourglass figure

An hourglass tummy tuck does more than just flatten the belly. Unlike a traditional abdominoplasty procedure, an hourglass tummy tuck addresses the entirety of the waist, belly and hips for a classic, hourglass shape. This specialized body contouring procedure combines a tummy tuck, liposuction, and fat transfer procedures to dramatically transform a patient’s figure, creating an hourglass silhouette.

If you are considering abdominoplasty, here’s why an hourglass procedure may be right for you:

What Is an Hourglass Tummy Tuck?

The hourglass tummy tuck is three procedures in one. The surgery incorporates a traditional tummy tuck to address excess skin in the belly, as well as liposuction to remove fat from the belly, love handles and lower back. This fat is then transferred to the thighs, creating a more prominent hip-to-waist ratio for an hourglass shape.

Because it includes multiple procedures performed at the same time, the hourglass tummy tuck can help patients save money and recovery time.

How is the Hourglass Different from a Traditional Tummy Tuck?

A classic tummy tuck procedure removes excess skin in the abdominal region and addresses underlying muscle for a flatter, tighter belly. This excess skin is typically the result of lost elasticity following pregnancy or significant weight loss.

A traditional tummy tuck does not include liposuction or fat removal, nor does it address the waist and back-side. For this reason, some who undergo a tummy tuck procedure are disappointed it did not give them the slim waist and hourglass figure they were hoping for.

The hourglass tummy tuck is actually three procedures in one. It includes a traditional tummy tuck, but also liposuction and fat transfer. Together, these last two procedures are sometimes referred to as ‘liposculpting.’ This fat transfer process is the same technique behind the popular Brazilian Butt Lift.

While a tummy tuck alone can sometimes leave women with a square figure, the hourglass tummy tuck specifically enhances the body’s contours to emphasize a smaller waist and less narrow hips.

Who Is an Ideal Candidate for An Hourglass Tummy Tuck?

The hourglass tummy tuck is ideal for anyone who wants to enhance their midline with a slimmer, more defined waist. Fat transfer enhances this contour by addressing narrow hips.

The ideal candidate is a non-smoker who is in generally good health and within 20% of their ideal body weight. The hourglass tummy tuck includes liposuction, but it is not a weight-loss procedure. Candidates should have just enough fat (about a one-inch pinch worth) to transfer to the thighs.

As with any tummy tuck procedure, future pregnancy, weight gain or significant weight loss can negate your results.

How is the Procedure Performed? 

The hourglass tummy tuck procedure takes more time than a classic tummy tuck, although the recovery process is very much the same. The 2–4-hour surgery is performed under general anesthesia.

Liposuction: First, liposuction is performed to remove excess fat around the abdominals, love handles and lower back. Addressing the front, sides and back of the body creates a smaller waist.

Tummy Tuck: After liposuction, excess skin is removed and the abdominal wall is tightened, resulting in a flat belly. The tummy tuck may also address umbilical hernias, diastasis recti or the look of the belly button.

Fat Transfer: Fat that has been removed is then purified and injected into the hip area, creating an hourglass shape. This technique-reliant body contouring process is best done by a skilled and experienced surgeon.

What Results Can I Expect?

The hourglass tummy tuck results in an enhanced waist-to-hip ratio. In addition, it offers the following results, all in a single procedure:

Improved Abdominal Tone: By correcting for lax muscular structure, the hourglass tummy tuck can improve posture and lower back pain. It may also correct for hernias or diastasis recti. Cosmetically, it results in a flatter belly.

Tighter, Smoother Skin: By removing excess, sagging skin, the hourglass tummy tuck results in a belly that appears more youthful and smoother.

Excess Fat Elimination: Liposuction in the area removes stubborn pockets of fat in the belly and around the waist that are difficult to target with diet and exercise.

Enhanced Silhouette: Transferring fat to the thighs will not make them ‘fat.’ Instead, this contouring procedure helps emphasize a slim waist, resulting in an hourglass silhouette.

How Long is Hourglass Tummy Tuck Recovery? 

Although the hourglass procedure is more extensive than a traditional tummy tuck, the recovery period is the same.

Expect swelling, redness, and bruising in the first 1-2 weeks, during which time you’ll be asked to emphasize rest. Between weeks 3-5 you should be cleared to return to most daily activities, although some abdominal discomfort may remain. A full recovery, including the ability to return to full exercise, is expected between weeks 6-12.

Are There Any Side Effects?

As with any surgical procedure performed under general anesthesia, there are some risks. Risks include delayed incision healing, unexpected scarring, infection, tissue damage or changes in skin sensation. These risks are rare and can be drastically minimized when your surgery is performed by a reputable, board-certified surgeon.


Cameron Erickson, MD

Dr. Cameron Erickson is a native Texan and board certified plastic surgeon practicing in the Southwest Parkway and Dripping Springs locations. Dr. Erickson specializes in aesthetic procedures including rhinoplasty, brow lifts, eyelid surgery, lip lifts, facelifts, breast augmentation and lifts, breast reduction, body contouring and liposuction, abdominoplasty (Tummy Tuck), brachioplasty (Arm Lift), 360° liposuction with fat transfer to the buttocks, vaginal rejuvenation, and hormone replacement therapy. In addition, he has had additional training in non-surgical treatments including injectables (Botox/fillers), lasers, and skin resurfacing treatments.


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