Prominent, Rock Hard Belly - Diastasis Recti? (Male)

It is likely that your husband's fat is inside the abdominal cavity, as is common in men, and not just under the skin. If that is the case, his best option is to loose weight with a combination of diet and exercise. A tummy tuck is unlikely to make a significant difference.

Men carry their fat on the inside of the abdominal cavity more than on the outside, which is where women carry more fat.  As a result, a man can have a big round tummy WITH VISIBLE ABS on some occasions in spite of an excess of body and abdominal fat.  A tummy tuck or liposuction will not fix this problem, since the fat must be lost in order to shrink the abdomen.  As a result, diet is the key to improvement rather than surgery.  Once the weight is lost, it's possible that skin removal might be needed, but often times there's not much loose skin, depending on how long the person was overweight and how extreme the weight gain/loss was. 

Thank you for your question and photographs, and I can see your area of concern. Based on his ultrasound findings, your husband has a separation of his "six-pack" muscles from his belly button up to his breast bone. In males this is most commonly caused by weight gain inside of the stomach, around his internal organs.  It is possible to fix this separation, but it will not significantly change is outer appearance.  I would recommend he pursue a healthy diet and exercise regimen, perhaps supported by a nutritionalist and trainer who can help him lose weight.  This weight loss will help reduce the protuberant aspect of his stomach, but may leave him with a bit of skin excess. Should this occur, a male tummy tuck can be performed to repair is separated muscles and remove any skin excess in a single setting. Hope that this helps.