Since time immemorial, a narrow waist is a much-coveted feature on women, particularly if it is complemented by wider hips. According to several studies, a waist-to-hip ratio of 0.7 or at least near this number generally signifies good health and female fertility, thus there seems a biological reason why men are attracted to females with an hourglass figure.
In an attempt to narrow the waist and create a more hourglass figure, some women ask for plastic surgery—particularly with a tummy tuck and liposuction.
If the “thick” waist is primarily caused by excess fat—or particularly the superficial fat found underneath the skin—liposuction alone is enough to create a drastic, long-lasting result. It involves just a few small incisions the size of a grain of rice where a suction probe or cannula is fit inside and then pulled back and forth to dislodge and remove the fatty tissues.
But as with any body sculpting surgery, liposuction is only reserved for patients who are closed to their ideal weight. First and foremost, surgical removal of the deeper, obesity-related visceral fat, which covers the organs in the abdominal cavity, is deemed to be too risky.
Visceral fat only responds to weight loss, which is only possible through regular exercise and healthy diet. In contrast, superficial fat can be surgically removed because it sits just underneath the skin.
For many patients whose goal is to achieve a narrower waist through liposuction, the flanks must also be treated to further contour the midsection.
However, a large waist that is mainly caused by muscle separation due to pregnancy and/or massive weight gain will not respond to liposuction. Instead, tummy tuck is the only appropriate “tool” because it often uses a hip-to-hip incision to remove the hanging tissue and tighten the splayed abdominal muscle.
In some cases, liposuction and tummy tuck are performed at the same time to further recreate the hourglass shape.
While these two procedures have their narrowing effect, it is important to note that the overall improvements are still largely affected by the underlying anatomies, i.e., muscle and other soft tissue, and pelvis.
Meanwhile, rib removal in an attempt to narrow the waist is rarely performed in the US because of the risks since the ribs are necessary to protect the internal organs from trauma.
The controversial procedure involves the removal of the 11th and 12th ribs, with their rear portion left behind to at least maintain some of their functional purpose.