Best Way to Get Rid of Lower Belly Pouch

I am 36 yrs old, 5'9", 130lb, and work out intensely 5 days a week. I eat healthy and consider myself in excellent health BUT for the life of me I cannot get rid of my lower belly pooch!! I have strong abdominal muscles but always have a pooch, especially after eating - I tend to bloat easily.

I have read about the different methods to flatten the tummy and I know that I want the method with the least amount of scarring. Please let me know which method you would recommend and what kind of scars I can expect. Thanks!

Doctor Answers 19

Best procedure for lower abdominal pouch

Without an examination, it is difficult to say for certain, but from the photos, I would guess that you have some excess fat in your lower abdomen, and would likely get a great result with liposuction alone, without any skin removal. You do not appear to have loose skin from the photos, so an abdominoplasty would not be necessary, unless your rectus abdominus muscles are seperated. Only an exam would be able to clarify this. GOod luck!

Newport Beach Plastic Surgeon
4.9 out of 5 stars 106 reviews

Liposuction vs mini-tuck

The procedure with the least scars is obviously liposuction and based on the pictures alone you might be a candidate for that.

Upon physical examination a mini-tuck can be required depending on the amount and degree of skin laxity in the lower abdomen. Commonly a combination of mini-tuck and liposuction is performed to address both the upper and lower abdomen and in your case maybe the flanks as well, which will give you a more uniform result.

I agree that without an actual physical examination it is near impossible to pick the right procedure/s based just on photographs.

Antoine A. Hallak, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 5 reviews

That all depends what is causing the pooch

From the picture, it appears to me to be just a small amount of excess fat. If this is the case, then I would recommend liposuction. This would require just one tiny scar in your pubic hair.

If however, there is no excess fat, and the pooch is due to prominence (rounding) of your abdominal muscles, then muscle tightening would likely be the only way to flatten your belly further. This would require a mini tummy tuck scar about as long as the width of your pubic hair.

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 113 reviews

Lower abdominal pouch

The lower abdominal pouch can be a difficult area for people to lose without surgery. First you need to be examined to make sure that there are no other causes for it.  Most likely you will need some sort of lower abdominal wall tightening.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Picture is not worth a thousand words sometimes

You have gotten the best advice: schedule a consult with a board certified plastic surgeon. You have a difficult case to give an opinion based on a photo. The surgeon will have to physically touch and feel to see if you have abdominal wall weakness and/or loose skin or predominantly fat. Based on your exam you could be an candidate for liposuction only or a limited abdominoplasty.

Schedule a consult.

Treatment for lower abdominal bulge

Looking at your photos and assuming you have normal abdominal muscle tone, as you have described, I recommend liposuction for you lower abdomen.

You do not have any loose skin or stretch marks and, based on the photos, have normal skin tone. This is the perfect scenario for liposuction. It also has the least amount of scarring, compared to other surgical procedures.

You may want to consider liposuction of the upper abdomen as well, so that the upper and lower abdomen have better harmony.

Good luck.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon
4.7 out of 5 stars 13 reviews

How to improve the appearance of your abdomen

It used to be that a tuck was the only option for a woman with a bulging tummy. Then liposuction came along, and we could do a smaller procedure with virtually no scarring. It would help if we knew if you have been pregnant before because pregnancy causes the abdominal muscles to separate and the skin to hang.

Liposuction works best on patients who are of relatively average weight, but who need help with a problem area, or with shedding the ten pounds they regain between diets. Liposuction modifies volume by sucking out fat, and liposuction candidates need good skin tone. Because liposuction stimulates the skin to tighten, good elasticity provides a smooth contour after fat is removed. Many times, liposuction of one area provides a good jump start for further dieting and exercise, allowing you to continue to lose weight.

You might be a candidate for Zerona. ZERONA® has been FDA cleared to reduce inches with no pain, no surgery and no downtime. Patients are losing between 3.6 to 5.5 inches and many are seeing even greater results when combined with a sensible diet and exercise program. It's the perfect way to lose stubborn body fat from: neck, love handles, arms, hips, back/bra line, thighs, tummy/waistline and knees in this fast paced world we live in.

After just six 40 minute treatments you will see inches melt away. And best of all, there is no recovery or downtime so you can resume all your normal activities immediately after each treatment. We also provide you with a nutritional and exercise routine to make shedding inches even easier. However, it is difficult to determine the right treatment for you without an evaluation.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Get rid of lower belly pouch

For me the easiest way if doing a minor surgery is the SmartLipo at 35 watts MPX unit. I love the skin tightening and final results.


Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Diastsis repair with or without mini tuck

In all probability, you probably have a diastasis, which is a separation of the abdominal recti muscles. They run up and down in the abdomen and help contribute to the so called 6 pack.

As far as scarring, this can be done endoscopically, but if you have extra tissue, skin or fat in the lower abdomen, which is hard to tell by the picture, then you may benefit from a mini-tuck.

Sharon Theresa McLaughlin MD
Long Island City Plastic Surgeon

Lower abdominal pooch treatments

If you have not had children, and if this is extra fat - liposuction is your answer. If you have had children and we are seeing muscle laxity, a tummy tuck is your answer. If you develop intra-abdominal bloating and gas that distends your abdomen as the day goes by, you need to modify your diet.

Best plan is to see a plastic surgeon and determine which of these fits your situation best.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 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.