Loose Skin or is It Fat?

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.

Dear Livinthedream,

Thank you for reaching out and sharing your concerns. Based on your description, it sounds like you may be experiencing a combination of excess fat and loose skin in the lower abdominal area, commonly associated with muscle separation, also known as diastasis recti.

Diastasis recti occurs when the abdominal muscles separate, often as a result of pregnancy or significant weight fluctuations. This separation can create a bulging or protruding appearance in the midsection, even in individuals who are otherwise fit and toned.

Given your history of pregnancy and the changes you've noticed in your abdominal area despite your efforts with a personal trainer, it's possible that you have diastasis recti contributing to the appearance of your belly. In cases like yours, a tummy tuck procedure can be incredibly beneficial.

A tummy tuck, or abdominoplasty, is a surgical procedure designed to address excess abdominal skin, tighten weakened or separated abdominal muscles, and remove stubborn pockets of fat. By repairing the muscle separation and removing excess skin and fat, a tummy tuck can help restore a flatter, more contoured abdomen and improve overall body proportions.

I recommend consulting with a board-certified plastic surgeon experienced in performing tummy tuck procedures. During your consultation, your surgeon can evaluate your abdominal area, discuss your goals and concerns, and recommend the most appropriate treatment plan to help you achieve the results you desire.

Sincerely,

Dr. Katzen
Plastic Surgeon

Thank you for your question. It is hard to provided with a valid medical opinion without photos.  I would suggest to be treated by board certificated plastic surgeon with experience in this procedure, to get the best desired results.
Kind Regards,Dr. Emmanuel Mallol Cotes.-

Thank you for your question.  Your set of complaints is a very common one.  The laxity in your lower abdomen is likely more than simply extra fat and/or skin - it is the stretching of the tissues that make up the abdominal wall due to pregnancy.  These are all issues that are corrected with tummy tuck:  removal of excess skin and fat from the lower abdomen, as well as tightening of the abdominal muscles and fascia with corset plication.  In the hands of an experienced, board-certified plastic surgeon, the result is a beautifully flat tummy and a sculpted waistline.

whether you'd be better suited for liposuction or a tummy tuck. Often that pouch of extra fat after childbirth (or before) is amenable to liposuction. Good luck.

This is most likely because what you are talking about is skin excess. You have done the right thing by working out.  Instead of getting frustrated and giving up, it may be time to have the skin excised and the muscles tightened with a tummy tuck.

                  It’s
not unusual to see women who have concerns about the appearance of their abdomen
following pregnancy.  Most of them
have tried diet and exercise and despite this have been unable to solve their
problems.  These patients have
difficulty finding clothes that fit properly and feel that people stare at
them.  This often results in lowered
self-esteem, self-image and self-confidence.

                   A
variety of changes can occur in the abdominal wall following pregnancy.  These include the development of excess
skin, weakened abdominal muscles and fat accumulation.  For these reasons, a comprehensive evaluation
is essential to obtain an optimal result. 

                  Depending
on the results of this evaluation, multiple options are available for treating
abnormalities of the abdominal wall. 
Two of the most commonly used procedures are tummy tuck and liposuction.  These procedures have different levels
of complexity, pain, recovery, and cost. 

                  When
isolated fat is present, liposuction can be performed under local or general
anesthesia.  It has a relatively
short recovery, is affordable, and has a low complication rate.  The procedure involves passing a canula
through the subcutaneous tissue while applying suction which ultimately removes
fat cells.  High satisfaction rates
are associated with this procedure. 
Its major drawbacks include less effectiveness in patients with weak
abdominal muscles, loose skin, and large amounts of fat.

                   Abdominoplasty
tightens the abdominal wall muscles and removes excess
skin and fat.  When severe
deformities are present abdominoplasty is the treatment of choice.  High satisfaction rates are associated
with this procedure, but it is more expensive, has a longer recovery and a
higher complication rate.

                   For
patients with severe abdominal wall deformities, it’s essential that the
appropriate procedure be chosen to correct the problem.  For this reason it’s important to
consult a board certified plastic surgeon who can perform this evaluation.

Congratulations on being so faithful to your exercise regime. You must be in great shape. Unfortunately it is very difficult, if not impossible, to get rid of loose skin concentrated in your midsection. You can wait for a while to see if your skin tightens but generally this does not happen as it is worsened by the aging process. A tummy tuck is the only procedure that can dramatically improve the contour of your midsection  by removing loose skin and extra fat. Because you're in such great shape your results will be even better than someone who is not in good shape.

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.

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.

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.