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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!

Doctor Answers (20)

There are many causes for abdominal fullness


Don't worry, you have a common concern. There are many problems leading to abodominal fullness. First is fat, but you seem to be exercising well without any change in your abdomen. The second is diastasis of your abdominal muscles. When you have children the fascia holding your rectus muscles (six pack) together becomes loose and the abdomen has a round appearance despite exercise and weight loss. In this case, you may require a surgery (abdominoplasty or "tummy tuck") to tighten the muscles back together and to excise any extra skin. This is a common operation. The incision can be hidden in your waist line and the surgery can be combined with liposuction to help define your flanks and remove any excess fat.

The best way to tell if you have fat, extra skin, or diastasis of your muscles is to feel your belly.

If you can "pinch and inch," then there is fat which may be improved with liposuction.

If all you feel is loose skin, then it is likely a skin issue requiring abdominoplasty.

If your abdomen remains round despite tightening your muscles (six pack), then you likely have diastasis requiring tightening.

Good luck.

New York Plastic Surgeon
5.0 out of 5 stars 52 reviews

Hard to tell with out an examination of abdomen


Hard to say with examining you. An in person visit would be best to give you the right information. It can be either loose skin and muscles that would require a Tummy Tuck/Mini Tummy Tuck surgery. It sounds like you have been very good about exercise and if surgery is recommended you will be better prepared due to your good physical condition. Strong abdomen muscles is good to have during the recovery and you will get a great result in whichever procedure you need. A Board certified Plastic Surgeon will make this determination after a complete examination.

Web reference:

Manhattan Plastic Surgeon
4.5 out of 5 stars 22 reviews

The excess contour could be abdominal wall laxity, skin or fat or a combination


There are several components of extra fullnes or contour in the lower abdomen.

There can be excess contour from laxity of the abdominal wall (it was stretched out during pregnancy), or excess skin, or excess skin and fat.

A board certified plastic surgeon will be able to ascertain upon examination of your abdomen what is causing the fullness you don't like and advise you.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Loose Skin or is It Fat?

The question cannot be fully answered without a formal physical exam but seems to suggest that there is muscle weakness in the lower abdomen.  I find this to be very common after multiple pregnancies and correction with a mini or full tummy tuck has been very successful.  
Orange County Plastic Surgeon
5.0 out of 5 stars 3 reviews

Tummy tuck for persistance fat accumulation in the lower abdomen following pregnancies


 It is quite possible that the lower part of your abdominal muscles has been streched out or separated as a result of multiple pregnancies, therefore some of the intra abdominal fat is protruding through the midline. A careful clinical examination would be helpful to diagnose this condition which could be fixed during a modifid tummy tuck. If that is not the case liposuction/liposelection is a very effective procedure to address your concerns.

Web reference:

Minneapolis Plastic Surgeon
5.0 out of 5 stars 11 reviews

You most likely need a tummy tuck which is not unusual after prgnancy.


It sounds like you are in very good shape now but have a stubborn collection of loose skin that cannot go away with exercise.    You may also have some separation of your abdominal muscles as a result of pregnancy.  This can also be corrected during a tummy tuck.

Web reference:

Toronto Plastic Surgeon
5.0 out of 5 stars 25 reviews

Loose skin vs. fat. Tummy tuck an option?


Hard to tell without photos or exam.  There can be several factors at play.  Tummy tuck is good for repair of diastasis recti (separation of rectus muscles).  It is also good for loose skin.  If there is only fat and no loose skin, liposuction may be a good answer.  Best to see a board certified plastic surgeon for a proper exam.

Web reference:

Las Vegas Plastic Surgeon
4.5 out of 5 stars 7 reviews

Schedule a Consultation to See If Tummy Tuck is the Answer


During pregnancy the stretching of the uterus can cause the muscles in your abdomen to separate down the vertical line called the linea alba. This weakens the abdominal muscles, making it harder to hold your stomach in. While some cases can be ameliorated with exercises, the most effective treatment is abdominoplasty surgery (tummy tuck) to reattach and tighten these damaged muscles.

Another issue could be the amount of skin and/or fat you have left over after pregnancy. While working with a personal trainer is most definitely a step in the right direction, it’s true that the lower abdomen is one of the hardest areas for women to lose the “pooch” and gain muscle definition. For some women, gaining muscle in the abdomen while still hanging on to a small amount of fat can result in a larger looking belly. I suggest you research plastic surgeons in your area and schedule a consultation in order to determine the cause of your issue, and he or she can recommend which steps to take to help you reach your cosmetic goals.

Atlanta Plastic Surgeon
3.5 out of 5 stars 14 reviews

Loose Skin or Fat


You are an ideal patient for a tummy tuck if you have 3 things; 1. loose skin, 2. any extra fat, 3. a diastasis rectus after having children. This makes an ideal patient for abdominoplasty. Abdominoplasty is not about weight loss as much as shaping and contouring your pre-operative silhouette especially after children.

Dallas Plastic Surgeon
5.0 out of 5 stars 12 reviews

Abdominoplasty might be a great option for you...


Abdominoplasty (or tummy tuck) sounds like it would be a great option for you.  It sounds like you have done a great job exercising and doing all you can to lose excess fat.  When exercise doesn't give the desired result, abdominoplasty should work great for you.  Abdominoplasty is a surgical procedure designed to flatten your protruding abdomen by tightening the muscles and removing excess fat and skin.  Another option may be a mini tummy tuck.  With a mini tummy tuck a smaller incision is made and no incision is made around around your belly button.  To discuss the best option for you make sure you consult with your surgeon.

Edison Plastic Surgeon
5.0 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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