What can I do to get "six-pack abs"?

I assure you, you already have the 'six-pack' that you desire, but its likely buried beneath a layer of abdominal fat. Without the benefit of seeing your photographs, it's difficult to say if there is a surgical option for you; there might be, but none are very effective.

Frankly, the best way to define the abdominal muscles that you currently have is to lose the excess body fat you have the old-fashioned way: diet, exercise and possibly a little genetics...

If you're spending a lot of time in the gym, it may be worthwhile spending a couple of work-outs per week outside of the gym riding a bike, speed hiking or running for an hour. There is no question that sustained aerobic activity a couple of times per week is the best way to burn fat, improve your cardiovascular status and crank up your metabolism. Plus, it's a heck of a lot more fun than spending an hour at the gym.

It's not a wasted effort: the muscle bulk you've attained by hard work in the gym will only be more defined and visible by shedding some excess body fat. You won't lose the muscle bulk.

As for diet: shed the carbs. It's as simple as that. Drop the pasta, chips, bread and bagels and replace them with a vegetarian dish. Keep your protein intake at what you would normally eat per your trainer's recommendations (1.5-2 grams/kilogram of body weight per day). Stay hydrated with WATER.

As for genetics: you either have got the 'skinny' gene, or you don't. If you don't, then you're going to have to work a little harder than Carlos Sastre, winner of the 2008 Tour de France, who has got the 'skinny' gene. Oh, wait: it's impossible to work harder than that guy!

In summary: surgery is probably not the answer. Diet and training, and a little luck, are your best bet.

Most Kindly,

Scott C. Sattler MD FACS