How do I get rid of the mom pouch? Lipo? Tummy tuck? (Photo)

First, congratulations on your weight loss.  It sounds like you are leading a healthy lifestyle with diet and exercise, but the "mom pouch" is a common concern for women who have had children.  While sometimes diet and exercise can return the body to a flatter shape after pregnancy, it is normal for women to have this excess skin or fat on their lower abdomen.  Especially after having four children, you likely have an element of diastasis, or stretching of the muscle, that would be difficult to return to normal with diet and exercise alone.  A tummy tuck would be a good option to tighten this muscle, remove some of the excess skin and fat, and return the abdomen to a flatter shape.  A tummy tuck, or abdominoplasty, can be done as an outpatient surgery in a surgical center, and a patient can expect 1- to 3-weeks of discomfort, and a general healing time of 6-weeks to 3-months to see the final results.  You would have a scar that runs across the lower abdomen at the bikini line, and also around your belly button, as we would need to move the belly button up after removing the excess skin.Liposuction would remove some of the excess fatty tissue of the lower abdomen and mons, but you may have excess skin after surgery, and the underlying muscle would still "bulge."  This is an option for you, but may not yield the best results.I recommend consulting with a Board Certified Plastic Surgeon to come up with a surgical plan that is tailored to your specific desires.Best,Nagi Ayoub, MD, FACS

Since you have had four children, part of your pooch is most likely due to stretching or separation of your abdominal muscles. Therefore, I think you will achieve your best cosmetic appearance with a tummy tuck combined with abdominal liposuction. Good luck!

Congratulations on your recent weight loss and healthy lifestyle change! Liposuction will help remove stubborn fat, but only a tummy tuck will remove loose skin that causes that mommy pouch and repair the muscles to their pre-baby position in order to give you a flat stomach. I would recommend scheduling a consultation with a board certified plastic surgeon in your area. Remember, you want to be at a stable goal weight before proceeding with a tummy tuck. Best of luck!

I think you would get considerable improvement from liposuction only but the best final contour would require an abdominoplasty.

I appreciate your question.Typically I would recommend surgery for your problem.But if you have other medical issues then i would recommend something external like coolsculpting.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.best of luck!Dr Schwartz

Without an examination, it is hard to tell how much of your "mom pouch" is due to fat and how much is due to weakness of the stomach muscles following your pregnancies.  Liposuction can get rid of fat but it won't tighten up the stomach muscles.  That would require a tummy tuck.  Based on your pictures, I would think that you are a better candidate for a tummy tuck but I would suggest scheduling a consultation with a board-certified plastic surgeon who can examine you in person and review your options with you.

Based on your photos, it looks like you
will benefit from either liposuction or a tummy tuck. Given the fact you had 4
kids, muscle stretching is very likely contributing 50% of the bulging of your
tummy and your skin elasticity will be unreliable. To get a home run in one
operation, I would recommend a tummy tuck . . . it is a more involved procedure
overall, but will also give you the most dramatic results. It is work fully
discussing both options with a plastic surgeon that performs a lot of body
work. Thanks for sharing!

Congratulations on your weight loss so far.  I would recommend you continue to loose weight and then undergo a tummy tuck.  You have fascial laxity that causes your abdomen to bulge out and only with a tummy tuck will this be flat again.  You would be unsatisfied with only liposuction.  

It is difficult to discern your skin quality from the pictures but an abdominoplasty, liposuction or combination of the two would improve your abdominal contour. Liposuction offers removal of the fat excess and resultant tightening of the skin depends on your skin quality. Abdominoplasty removes both the excess fat and skin while also tightening the abdominal muscles that often get lax after multiple pregnancies. A combination of the two can improve adjacent areas and if there is any excess upper abdominal fat. Recommend evaluation by a Board Certified Plastic Surgeon to discuss your options and goals. 

You are border line TT vs Lipo. I might offer aggressive liposuction to remove abdominal fat..........