Extended Belly Treatment Options?

I am male, 46, and have an extended belly, but no fat, no loose skin, none of the indicators that Liposuction and Tummy Tucks are relevant. I have held this bulge in for 25 years, it has never got worse or better, even when I have done sit-ups and Pilates. When I breathe in and pull my muscles in, my stomach flattens nicely to the way it should look; the muscles are in place, not split.

Some websites say this is not uncommon in males and recommend plication; there is no fat I need to have removed and no skin that needs folding or removing. In most respects, my physique is attractive, as long as I hold my stomach muscles in. Is plication indeed an option at this point, or are there other options? I attached a photograph, if it helps.

Doctor Answers 7

Recontouring an extended abdomen

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There are many options for recontouring did on the wall. If you do not have excess skin or fat is possible that your extended abdomen may be due to the contents of your abdomen rather than the surface. Your best bet is to be evaluated by a board-certified plastic surgeon who is experienced in abdominoplasty and body contouring techniques. They will be able to examine you and determine if you are a candidate for removing extra skin and fat that remained on the surface of the abdominal wall. If your abdominal volume is mostly inside the abdominal cavity, this will respond to exercise and a low-fat diet.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

A tummy tuck may be the answer

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Based on your photo, a tummy tuck with particular attention to plication of the muscles of your abdomen may indeed be the best option to improve your abdominal profile. I agree it does not appear as if you have any significantly extra skin or fat, but that doesn't mean a tummy tuck is the wrong option.

The incisions are the same, the muscles are tightened and then the skin is redraped (a little skin is usually removed) and the incision closed.

My recommendation is to see an experienced plastic surgeon in your area, and get his or her thoughts, but in my opinion, it looks like a good option to consider.

Good luck,

Dr. Salemny

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Multiple factors for extended belly

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The abdominal protrusion in men is a combination of multiple things:

1. Exagerated Lumbar lordosis.

2. Intra-abdominal fat.(ometum)

3. Divercation of the rectus muscle.

4. Sucutaneous fat and skin.

A tummy tuck will only help with the last two. Diet will improve the intra-abdominal fat and nothing will change the lumbar spine! Hope that helps!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Male with distended tummy: what to do

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I would seek the evaluation of  a certifiied plastic surgeon to conduct an examination for a muscle separation. I believe you could get an excellent long term result with muscle re-education and supervised personal training sessions for core strengthening.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Not sure you can improve this over the long term

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Your intraabdominal contents are accustomed to existing in a larger space. If you try to compress them inward by tightening the rectus muscles, this repair will not last over the long term if there is too much intraabdominal pressure pushing back out against the repair.

Take the palm of your hand and see how much pressure it takes to push the abdomen inward. Hold the contents in for a minute and feel how much pressure it takes to maintain a flat abdomen. It is this pressure which the repair needs to be able to stand up to and just might not be able to do.

See an experienced plastic surgeon who can give you some good advice after examining you.

You have diastesis of the rectus muscle

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You will benefit from abdaminoplasty and repair of the separation of the rectus muscle. This can be done ith lower abdaminal incision . If you do sit up you will notice a bulge over the midline. Please  get more than one consultation and make sure your surgeon is board certified plastic surgeon.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Plication can address abdominal muscle laxity

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Abdominal muscle laxity is not uncommon. Sometimes this can happen in patients with poor muscle tone. It is associated with a "beer belly" with patients that have a large intraperitoneal fat component.

It would be important to evaluate you in person to get a better idea of what you need. If you truly only have muscle laxity, abdominal plication can be performed.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.