Loose skin, fat, muscle, or all of the above

Michael Diaz, MD answers: Loose skin or is it fat?

I am 37 years old and had 2 children 18 months apart. My youngest is now 5 years old.

I just completed a year of training with a personal trainer 3 times a week, but did not lose any of my belly fat below my belly button; it almost seems worse than when I first had my children. I also did not lose any weight but gained muscle and lost body fat.

My legs, hips, and arms are a couple of inches smaller, but my belly seems bigger than ever and is the same size. I'm considering whatever it will take to get rid of this pouch of fat - or loose skin. I'm not sure what it is, but it's gotta go!


Michael Diaz, MD
3 months ago

I think it's great that you have conditioned yourself through dedicated training. You may have some loose skin, fat, muscles or all of the above. After pregnancy, weight loss, and age, the muscles of the abdomen can separate. This leads to loss of the defintion of the waist and abdominal rounding or "pooching". This may be in conjunction with loose skin and excess fat.

I encourage you to continue to exercise. Unfortunately sit-ups I have found that sit-ups usually do not  flatten your abdomen because it does not bring your separated muscles together. More than likely your abdomen looks worse because the rest of your looks so much better. Once you have exhausted all exercise options, you may want to consider surgical correction.

From what you have described you may be a candidate for a mini tummy tuck, with or without liposculpture to the sides. This will flatten the lower abdominal pooch and add definition to your waist. The recovery is less than a full Tummy Tuck.

I reccomend that you seek a board-certified palstic surgeon for a full consultation and examination. Review with your surgeon what your goals are and the specific areas of your abdomen that you want to improve. I ask all my patients if they want to improve the appearance  of their belly button and to point with one finger all of the areas they want to improve. I learn more about the most appropriate surgical options just by listening. Ask alot of questions. Review before and after pictures.

Hope this helps.

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