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

My husband has a very prominent belly and really HATES it. He has had an ultrasound which stated "Diverification of recti in upper abdomen superior to umbilicus extending to the level of ziphoid, approx 21mm". Though there is this seperation, surely it cant be just this that is causing such a large, rock hard belly. He has minimal fat on the belly & would like to know if there is anything else he should look into, as he feels that a tummy tuck alone wont flatten it. (His dad is the same)

Doctor Answers 9

Prominent male belly

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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.

Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Rock hard abs

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Unfortunately in men a rock hard abdomen is more often caused by fat inside the abdomen pushing out than  from 1000 sit ups.  Men and women put fat in different places.  Women tend to put their excess on hips and thighs, or the external fat layer of the abdomen.  Men place it in the love handles and inside the abdomen around the organs.  His muscle separation is only about 3/4 of an inch and wouldn't tighten noticeably

Byron D. Poindexter, MD
Reston Plastic Surgeon

Rock hard belly

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It looks like your abdomen is distended because you are overweight.  The most important thing you can do for yourself is lose 15-20 lbs through diet and exercise.  You may not even need surgery if you do that.  Your skin looks great and should tighten up.

David Stoker, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 62 reviews

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Prominent, Rock Hard Belly - Diastasis Recti?

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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. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Abdominoplasty won't fix this man's problem.

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There is an excess of intraabdominal fat.  This cannot be removed by suction and abdominoplasty would make very minimal improvement with significant risk of complication.  Weight loss is the sensible way to deal with this specific problem.

Tummy Tuck Candidate?

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Thank you for the question and pictures.

I think it would be in your husband's best interest to be seen by a well experienced  board certified plastic surgeon. Simple physical examination will be enough to determine if your husband is a good candidate for any type of surgery. For example, if the “pinch test” demonstrates significant subcutaneous adipose tissue, he may be a good candidate for liposuction surgery. If, on the other hand, he has significant abdominal wall laxity (muscle laxity) he may benefit from tummy tuck surgery. Sometimes, especially with men, the adipose tissue may be intra-abdominal and he would most benefit from diet and exercise.

I hope this helps.

Omental fat in men

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What your husband has is intra-abdominal fat ("beer belly") caused by excess aft in the omentum and mesentery.  There is no surgical solution for this, only diet exercies and weight loss.

Visceral Fat

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While diastasis recti may contribute to some of this protrusion, it is most likely caused by visceral fat. This fat is far below the skin and surrounds the organs. I would suggest following a healthy exercise and diet plan to help reduce these fat stores, then consider surgery if desired to repair the muscle separation. 

Diet and Exercise

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Diet, exercise, and weight loss are the keys to helping your husband feel better about himself. I would not recommend surgery. Best of luck!

Christine Sullivan, MD
Columbus Plastic Surgeon
4.5 out of 5 stars 35 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.