how can I get back my six pack after hernia surgery? (photo)

Yours is a question that in different forms we are commonly asked by patients.  It would help to know, prior to answering it, what your height is, and what kind of hernia surgery you had, but, nevertheless, the salient points of this answer still pertain. One question that comes to mind is: after your surgery, for how many months did you refrain from exercise or restricting your diet in a manner to promote weight loss, or at least prevent weight gain? Another is whether, after, by your own account, working with a trainer, and following an "extreme diet", have you lost any weight, and, if so, how much? What was your weight when you had your "six pack"? In other words, just before you began your diet and exercise program, how much more did you weigh than when you had your "six pack".Three months is actually a rather short time period over which to achieve a radical change in your body shape and composition.  Most diet specialists will tell you that a realistic rate of weight loss for a normal middle aged man is 1-2lbs a week.  That means that if you were following any of a number of well-recognized diet programs, you might expect to have lost between 12 and 24lbs over this period of time. It is very difficult to sustain a rate of weight loss greater than this over a sustained period of time, and when people do, the weight loss is frequently a function of a decrease of other components of the body besides fat, such as protein, water, etc.   But visibility of your "six pack" is fundamentally a function of the percentage of body fat, of your ENTIRE body, not just your abdomen.  The inscriptions of the rectus abdominis muscles are usually not visible in a man until his body fat approaches about 12%, and become more highly defined as it continues to decline below 9%.  Looking at the picture you shared, I would estimate that your percentage body fat is in the low to mid 20s, so you still have a ways to go. There are techniques of laser liposuction that allow us to "etch" a pattern that resembles a "six pack" into the fat overlying the rectus abdominis muscle. In you, that layer of fat is still too thick to reveal your "inner six pack" lying just beneath it.  If you want to continue your efforts to get a "real six pack", remember this, though: a proper diet is 90% of the battle, and your exercise routine can probably contribute about 10% to that effort.  Vigorous exercise alone will never compensate for a poor diet or repeated food binges between efforts at dieting. Good Luck.

 Thank you for your question. Diet  and exercise are helpful in trying to reestablish the abdominal wall muscles. If the layer of fat above the muscle is too thick the rectus muscles may not be visible. A combination of liposuction and or cool sculpting may be helpful in thinning the abdominal wall in order to improve the visibility of the muscles. Best of luck Theodore T Nyame M.D.