The tummy tuck is used to make the abdomen firmer and flatter by removing the excess skin and fat tissue and strengthening the muscles on the abdominal wall. This way we create a more supple and strong abdominal profile. The surgical technique involves the removal of skin and fat tissue through a transversal incision in the supra pubic area that can be extended from one hip to the other. The length of the incision is variable depending on the quantity of tissue to be removed. So after a traditional tummy tuck, the patient will be left with a smoother abdomen that is flatter and muscle diastasis and umbilical hernia are corrected. But when we talk about the small middle area, we also talk about the flanks and the waist. These are not affected during the tummy tuck procedure. When the patient’s goal is to get a smaller middle area, I almost always recommend liposuction and fat transfer to the hips, or what we call the hourglass tummy tuck. Liposuction is beneficial because it will help us eliminate the adipose deposits on the flanks and also reduce the thickness of the fat layer on the abdomen. You might be asking why we need fat transfer if you want a smaller middle area. Usually, when my patients talk about a small midriff, they are actually referring to the hourglass curves – a waist smaller compared to the dimensions of the shoulders and hips. Without these curves, a smaller waist would be much less appealing. This is why I use the fat harvested through liposuction to re-inject it on the hips to create the beautiful curves all women want. The traditional tummy tuck procedure doesn’t work on the middle area. You can undergo the procedure and still have a square shape, which is not very well defined waist. The only procedure that can help you get a smaller middle area and an impressive visual effect is the hourglass tummy tuck that combines the surgical methods of liposuction, abdominoplasty and fat transfer to the hips.