Love handles are the pockets of fat along the flanks that can show through clothes and resist targeted workouts. They are common and they are not a sign of poor discipline. Genetics, hormones, and skin quality all play a role. Dr. Michael Baumholtz is a double board-certified Plastic Surgeon in San Antonio who keeps the process simple and safe. He explains what can be changed with liposuction, when skin needs its own solution, and how to plan recovery so work and family routines stay on track. The goal is a cleaner waistline and a plan that matches the body you have today, without gimmicks or hype.
Why Love Handles Stay Even With Healthy Habits
- Genetics and hormones influence where fat sits.
- Targeted exercise strengthens muscles but does not spot reduce fat in one area.
- Skin quality matters. Fat can be removed. Skin may or may not tighten to match.
He bases recommendations on three things: how much fat is present, how the skin behaves, and what the patient wants to change in clothing fit and silhouette.
Video: Liposuction
Who Is a Good Candidate
- Stable weight, usually with a BMI in the low to mid 30s or less. Contouring is about shape, not the scale.
- Good overall health and no nicotine use. Smoking, vaping, and nicotine replacements compromise blood flow and healing.
- Support at home for the first 48 to 72 hours.
- Realistic expectations. Liposuction sculpts. It does not change metabolism.
He plans with anatomy, clinical measurements, and standardized photos. He does not use body imaging tools for this area.
What Dr. B Evaluates Before Treatment
- Pinch thickness and distribution of fat
- Skin quality, including stretch marks and elasticity
- Back rolls and how they blend into the flanks
- Weight history and weight stability
- Medical conditions, medications, and nicotine status
- Patient goals in plain language
Non-Surgical Habits That Help
These steps do not spot reduce the flanks, but they support better outcomes and safer surgery.
- Steady nutrition with adequate protein, fiber, and hydration
- Consistent strength training to build lean mass and support posture
- Sleep and stress control to support stable body composition
- Alcohol moderation, especially around surgery
Liposuction of the Flanks
For defined pockets of fat with healthy skin, liposuction is the most predictable option.
How he does it
- Small incisions are placed in natural creases near the bikini line or back crease.
- A thin cannula removes fat using a measured, layered technique that protects natural contour lines.
- The goal is a smooth taper from the waist into the hips and lower back. No aggressive carving.
- Compression is placed at the end of surgery to guide swelling down in a controlled way.
Key point
Liposuction removes fat. It does not tighten skin. Great skin often yields a great result. Loose skin usually needs its own solution.
When Skin Tightening or Excision Is Needed
- Mild laxity can improve with time, compression, and steady habits.
- Moderate or severe laxity often needs surgical skin removal. Options may include a low belt line excision, a flank excision, or pairing flank liposuction with abdominoplasty when the front is also loose.
- Scars are discussed in advance. He places incisions low and flat when possible and reviews scar care so there are no surprises.
Energy based tightening devices may help mild laxity in select cases. Results are modest and do not replace skin removal when laxity is significant. He does not oversell device results.
When the Front Matters Too: Abdominoplasty
Sometimes the sides are only part of the picture. Loose front skin or stretched muscle can make the waist look wide. In those cases, abdominoplasty can flatten the front while liposuction shapes the sides. Each plan is individualized. Abdominoplasty and flank liposuction do different jobs. One flattens the front. The other sculpts the sides.
What To Expect on Surgery Day
- Measurements and standardized photos are reviewed in plain English.
- Anesthesia is provided by board certified professionals.
- Positioning is padded to protect nerves and joints.
- The operative plan focuses on symmetry and smooth blending across the waist, hips, and lower back.
- A breathable, properly sized compression garment is placed before leaving the operating room.
Recovery Timeline
- Same day evening: walk. Soreness often feels like a deep workout.
- Days 1 to 3: short walks, hydration, hygiene. Bruising is common. Wear compression.
- About week 1: many return to desk work with frequent breaks.
- Weeks 2 to 3: more energy. Light cardio with clearance.
- Weeks 4 to 6: most daily activities resume.
- Months 3 to 6: swelling softens. Final contour appears as tissues settle.
Follow ups include photos so progress is clear even when day to day changes feel slow.
Compression Garments
Compression supports comfort, reduces shearing, and helps skin drape as swelling improves. It should feel snug, not painful. Seams should not create lines. In San Antonio heat, choose breathable fabrics and plan outdoor time for mornings or evenings.
Activity and Returning to the Gym
- Walk early.
- Add light cardio once soreness is mild and swelling does not rebound after activity.
- Strength work returns in stages. Core and upper body first. Lower body and twisting later.
- If a workout causes soreness that persists to the next day, scale back and allow more time.
Managing Expectations
✓ What changes
- Waistline
- Side silhouette
- Clothing fit
- Overall proportion
✓ What does not change
- Metabolism
- Scale weight in a large way during healing
- Skin that is too loose for liposuction alone
Dr. Baumholtz favors a natural, conservative shape rather than aggressive fat removal that can create contour problems.
Safety First
- Careful review of health history, medications, and a strict no nicotine policy
- Sterile technique and thoughtful fluid management
- Reasonable operative times and staged procedures when safer
- Multimodal pain control that balances comfort and clarity
- Early walking and direct access to the team during recovery
Combining Procedures
Common combinations include abdomen and flanks, or back rolls and flanks. When the front wall is loose, abdominoplasty with flank liposuction can create a balanced shape. Combining procedures can reduce total recovery time but adds anesthesia time. Plans are made case by case with safety as the priority.
Skin and Scar Care in Texas
- Tiny liposuction incisions usually fade to faint marks
- Once incisions are sealed and calm, silicone therapy can begin
- Gentle massage is added when directed
- Sun protection matters in Texas. Use UPF clothing and SPF after clearance and avoid direct sun early
Durability and Touch Ups
Removed fat cells do not grow back. Remaining cells can still enlarge with weight gain. Stable habits help results last. If a small area needs polish, he considers a touch up only after full healing so the plan is accurate.
Why Patients Choose Dr. Michael Baumholtz in San Antonio
- Double board certification in General Surgery and Plastic and Reconstructive Surgery
- Calm, direct explanations with emphasis on safety and durability
- Plans that fit the person’s body, schedule, and Texas climate
- Thorough follow up and access during recovery
- He does not take insurance for elective aesthetic surgery
FAQs About Love Handle Reduction Surgery
If my weight goes up and down, can liposuction of the love handles still give a lasting result, or will the shape change again with future weight shifts?
Results are most predictable when weight is stable. Liposuction changes contour, not metabolism. Large swings in weight can soften the improvement.
My abdomen looks flat from the front but my sides stick out. Do I really need a tummy tuck, or can targeted flank liposuction be enough?
A tummy tuck is not always needed. If front skin and muscle tone are good, flank liposuction alone is often appropriate. If there is loose lower abdominal skin or muscle separation, combining or staging a tummy tuck can make sense.
What technique does he typically use for flank liposuction, and why?
He often uses power-assisted liposuction and follows SAFE principles to help keep the surface smooth and even.
Will liposuction lower my weight, or is the benefit mainly in how clothes fit and how the waist looks?
Expect minimal change on the scale. The benefit is shape and fit, not pounds.
When can I get back into regular jeans without seams pressing on tender areas?
Often between weeks 3 and 6, once swelling and tenderness settle and seams no longer irritate the sites.
Do I need to wear a compression garment after flank liposuction, and for how long?
Yes. Compression helps control swelling and supports the new contour. Four to six weeks is typical in his practice.
What if one side heals a little differently than the other?
Healing is rarely perfectly symmetric. Small differences usually settle with time. If something persists after full healing, he will discuss simple options to refine it.
Is non-surgical fat freezing a good substitute for love handle liposuction in his practice?
He does not offer it. In his experience it has not delivered reliable results for his patients.
How soon can I exercise, lift, or do core work after flank liposuction?
Walking is fine right away. Ease back into workouts over the first couple of weeks. Avoid heavy lifting until tenderness and swelling are largely gone.
If I also need a tummy tuck later, can liposuction and a tummy tuck be combined safely?
Yes, when planned correctly. He often combines a tummy tuck with liposuction of the back or lumbar pads to enhance the waist, and he is cautious about liposuction in the exact area being tightened to protect healing.
Medical References
- Concepts, safety, and techniques in body-contouring surgery - Cleveland Clinic Journal of Medicine - https://www.ccjm.org/content/87/6/367
- Laser liposuction in interventional radiology - Techniques in Vascular and Interventional Radiology - https://www.sciencedirect.com/science/article/pii/S1051044313002054
Schedule a Private Consultation
Ready to talk with Dr. Michael Baumholtz in San Antonio about love handle reduction. Schedule a one on one consultation to review your goals and build a safe, tailored plan. Call the practice or request an appointment online to get started.
Further Reading
- Read more about Mommy Makeover
- Read more about Body Contouring
- Read Dr Baumholtz's Blog on Can a Tummy Tuck Fix Stretch Marks and Loose Skin?
- Read Dr Baumholtz's Blog on What Are The Long-Term Benefits Of Liposuction? [What to Expect]
- Read Dr Baumholtz's Blog on Tummy Tuck With or Without Liposuction: What’s Safer and More Effective?
