Flat stomach: what are the possible cosmetic surgery procedures?

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[EN VIDÉO] How much water is in the human body?
Answer to this question: it depends! The proportion decreases during life, from 80% in the fetus to 50% in the elderly. Between the two, the adult woman retains about 55% and a man rather 60%. And inside the body, the amount varies widely depending on the tissue.

Abdominal fat is divided into two different layers. A surface layer located between 2 and 4 mm in depth, made up of small cells the size of seeds of couscous and a deep layer made up of fat cells, the adipocytes, which are much larger, from the size of a pea to that of a grain of corn. grape.

The surface fatty layer can be reduced by diet and intense and prolonged sporting activity. The deep layer remains stable most of the time, melting only after a massive loss of weight, which sometimes even a bariatric operation cannot eliminate. The only solution then is to perform a liposuction of which there are currently a large number of modalities that we will consider.

What is the natural evolution of the silhouette in women and in men?

In women, there are three pivotal periods during which she will change her body:

  • the puberty where there is an obvious and well-known hormonal transformation;
  • the quarantine period or after one or more pregnanciesthe woman’s body thickens in particular at the level of the belly, the sides, the torso, and the upper part of the thighs and buttocks;
  • the post-menopausal period where there is often overall weight gain, but in other cases limited to the upper half or lower half of the body.

Lincrease in the abdominal circumference, as well as the ” tire » which goes around the belt, can occur quite early depending on the heritage genetic that patients easily recognize, compared to the person she most resembles in the family.

This explains why we are led to perform liposuction fairly early in a woman’s life, because when she notices this deformation of genetic origin, she has only one desire, which is to get rid of it earlier.

At the house of the man there are most often only two bodily changes during life:

  • the change after the age of fifty, with the appearance of bulges on the flanks, and the fatty invasion above and below the umbilical, which also causes the famous chocolate bars to disappear. These are in fact the visible reliefs of the indentations of the rectus muscles of theabdomenaspect considered very flattering in theanatomy masculine, because it bears witness to an athletic man who maintains his body well;
  • at the time of andropause, another change occurs in the male body with thinning of the covering skin, infiltrations of fatty tissue with more flabby and dry skin, especially on the limbs, face, and also at trunk level.

The ideal period to practice a modification by liposuction is therefore the fat storage phase which sometimes occurs after 40 years but often much later after 50 years.

What makes belly fat rolls ugly?

For many women, it’s not just these bulges of fat stored deep in the abdomen that cause an unsightly appearance. It can be associated with two other deformities that liposuction will not be able to improve:

  • distension of the rectus muscles creating a diastasis;
  • fatty infiltration of the omentum, which is a fatty tongue located around the intestines, so deep in the abdomen. This deep fatty mass is of course inaccessible to any idea of ​​aesthetic operation.

Liposuction with liposculpture is therefore only very specifically intended for patients who have deep but also residual fatty deposits after an attempt at a consistent and prolonged diet for at least six months.

Indeed, a liposuction performed on a patient who has lost little weight would be like slimming a bed from which the sheets and pillows have been removed without touching the cover.

What are the possible surgical or medical solutions?

  1. Injecting substances intended to melt deep fat is not yet developed, but research continues and is not necessarily to be ridiculed.
  2. The methods physical external such as cryotherapy (extreme refrigeration of masses deep fat) are a partially effective solution, but they have drawbacks. They only make it possible to treat relatively moderate surfaces, can give rise to fibrosis and unpleasant painful reactions, and are not exempt from recurrence in the medium term.
  3. The methods using the ultrasound external, or high frequency. They heat the tissues from the outside, in order to melt the adipocytes. They are an important source of hope for manufacturers of machines which are very expensive and which do not yet offer all the guarantees of efficiency.
  4. Assisted liposuction laserultrasound, plasma helium laser or argon laser. They have an interest in retracting the dermis by fan-shaped subcutaneous burns. But there are complications such as skin burns or leakage of gas, which are not entirely benign. A retraction of the excess skin is however effective at least at the beginning, without certainty that this result will last beyond two or three years of evolution.
  5. Liposuction assisted by a vibration electric. It has the enormous advantage of being less tiring for the surgeon who performs it. But the vibrations produced by the engine can also damage small nerves subcutaneous tenderness.
  6. Good old hand liposuction with dexterity and without brutality. It therefore remains ultimately as the best technique of safety and efficiency practiced by a patient and expert surgeon, who will also have to perform an act of sculpture. It was Doctor Yves Gérard Illouz, a French surgeon, who invented it in 1977. This surgeon therefore imagined a cosmetic surgery operation which remains the most practiced operation in the world and which has changed the lives of millions of people. women and made the fortune of manufacturers of tight jeans!

How to make the famous chocolate bars for men?

The technical principle is very simple but complicated to achieve: just turn the orifice of the cannula metal under the skin in order to remove a small amount of surface fat cells, if this gesture is practiced in a clever way with effective gentleness, it will result in a striation visible from the outside. It is of course also necessary to associate a small striation at the level of the deep fat to perfect the rounded side of these tablets of chocolate, which men love not for food, but for the muscular rendering of their anatomy which impresses both the female and male entourage.

What is the interest of contemporary lipofilling and liposuction?

Currently the exploitation of excess fat in the abdomen or flanks has grown considerably. Whenever a patient complains of insufficient volume of its boobsbreast asymmetry, a need for filling at the level of the nasolabial folds or at the level of the back hands, or as in certain ethnic requests, where a request for buttock augmentation is made…, in all these cases the surgeon can exploit the excess abdominal fat removed to dispose of it elsewhere, in the previously well-defined areas cited, but the patient should be warned that only 30% of the reinjected fat will survive. It is currently impossible to store this fat in a viable way in a fridge to reuse it secondarily, even the next day!

However, when it comes to creating the look of two chocolate bars on the male abdomen, there is no need for lipofilling at all, but rather deep and surface striation sculpting. in order to visually provoke this so sought-after appearance.


It is quite possible by an artifice of liposuction to create in the man and in the woman who would like it this disturbing appearance of chocolate bars at the level of the abdomen while significantly reducing the protrusion linked to the accumulation of deep fat in the belly and flanks.

But, obviously, it is not this palliative surgery that will create the real muscle fibers. There is need for the patient to understand that liposuction is only a step in the reconquest of his body, the essential being a coherent diet not to store deep or surface fat, and to practice a sports activity regular, which is the only one able to make him spend the calories inactive which otherwise accumulate in unsightly beads.

Manual and artistic liposuction remains the solution of recourse in safety and effectiveness when the patient has stabilized his diet.

To know more about Dr. Vladimir Mitz

Doctor Vladimir Mitz, is a plastic surgeon in Paris. He is an author who deals with plastic or aesthetic and restorative surgery through several of his works. He did all his medical and surgical studies in France. Former extern, then intern and head of clinic at Paris hospitals, he very quickly became interested in surgery. Intern in neurosurgery at the Lariboisière hospital, he had been fascinated by the precision and the technical quality of the operations performed on the brain. The human dimension of this surgery had thrilled him.

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