How can I get my flat stomach back? Surgical and non surgical options? (photos)

Thank you for your question and for sharing your history and photos. Based on your photos, you appear to have muscle weakness, particularly in the lower abdomen, which could explain the bulging appearance. This is not uncommon, even in individuals who exercise regularly, as factors like genetics, age, and core muscle strain over time can contribute to this issue. Let’s explore your options.

A mini tummy tuck could be a great surgical option for you if the muscle weakness and skin laxity are limited to the area below your belly button. This procedure involves a smaller incision compared to a full tummy tuck and focuses on tightening the lower abdominal muscles and removing excess skin in that region. The recovery time is generally shorter than with a full tummy tuck.

If the muscle weakness extends above the belly button or if you desire a more comprehensive correction, a full tummy tuck may be the better option. This would involve tightening the rectus abdominis muscles from the ribcage to the pubic area, addressing any separation or laxity, and removing excess skin for a smoother and flatter abdomen. This approach offers more dramatic results and is ideal for individuals looking to fully restore abdominal contour.

As for non-surgical options, treatments like Emsculpt can help strengthen your abdominal muscles by using high-intensity electromagnetic energy to contract the muscles beyond what you can achieve with exercise. However, these treatments won’t address muscle separation (diastasis recti) or excess skin. If your goal is a truly flat stomach and tightened muscles, surgery is the most effective route.

Since you’re active and already at a healthy weight, your surgical results are likely to be excellent. I recommend consulting with a board-certified plastic surgeon to discuss your goals, have your abdominal muscles evaluated, and determine the best approach for your specific needs.

Sincerely,
Dr. J. Timothy Katzen, MD, FASMBS, FICS

You would probably do very well with nonsurgical EMSculpt to tone and tighten your abdomen. If needed, liposuction could be added for any excess fat.

You demonstrate a weakness of the lower abdominal muscles. I would recommend Accufit electromuscular stimulation for a few treatments to see if this corrects the problem. In addition I would recommend specific Pilates type leg exercises to strengthen the obliques.If this does not work, the lower fascia can be tightened surgically.Hope this helps.