Is This Loose Skin or Fat Around my Stomach? (photo)

Thank you for your question. Based on your photos it look you have loose skin and some stretch marks, and you will get better results after tummy tuck with intense liposuction. I would suggest to be treated by board certified PS with experience in this procedure, to get the best desired results.Respectfully,Dr. Emmanuel Mallol Cotes.-

It appears that you have loose skin along with fat, and liposuction may not achieve the results you want. A tummy tuck may be more suitable. You can try exercising and dieting to see if it helps.

There are only two mistakes one can make along the road to truth; not going all the way, and not starting. -The Buddha

The correct answer to your question, Katie, is actually predicated on what your expectations are. In your post, you spoke of your desire to "get a flat stomach". However, examination of your pictures reveals that you have significant striae of the abdominal skin, meaning that this skin has been stretched beyond the point of its normal elastic recoil during your pregnancy.  

An honest answer to your question would have to include the advisement that, contrary to what you wrote, there is no way to "tone it up naturally." Additionally, the profile view of your abdomen suggests that your pregnancy has caused a diastasis recti and a weakening of your abdominal wall. Of course a complete physical examination would be required to confirm this.

Certainly, a well-conceived and carefully executed program of diet and exercise is never a bad idea, and no doubt it would improve your overall health, and your silhouette as well. For those areas where fat loss is recalcitrant to your diet and exercise program, liposuction may be helpful. Laser liposuction may also give you some additional degree of skin contraction, which in your case would be particularly helpful.

And, of course, you may not want to undergo an abdominoplasty until you are finished having children. But the bottom line in your case, when you speak of your desire to have a "flat stomach", is that the only procedure that will deliver a result that meets that standard, and will deal with your diastasis recti and stretched, redundant abdominal skin is an abdominoplasty. 

Liposuction is easy to undergo when done under local tumescent anesthesia and will make a big improvement in the abdomen and hips for roughly $5-6000 on special. Of coarse a tummy tuck will give the best results but that can be done later when done with kids. Sincerely,

david hansen,md

            There appears to be some compromise to the skin quality after pregnancy and the abdominal wall may be a bit lax.  A physical exam would be necessary to confirm.  If you are opposed to the tummy tuck scar, liposuction may be of benefit.  The liposuction for the stomach can be performed through two tiny incisions in the pubic region.   Find a plastic surgeon with ELITE credentials who performs hundreds of liposuction procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

If serious aggressive exercise + dieting can help. But even liposuction is a SURGERY! Seek a few IN PERSON opinions from boarded PSs in your city. 

From your history and posted photos, you have laxity of the abdominal wall, accumulation of fat in the skin and stetch marks. Eventually you will become a candidate for a tummy tuck after you are done with your childbirth. Until then loosing weight, tonining your muscles followed by liposelection would be a good plan for you.

I often consult women with your exact same dilemma....After pregnancy, many things change with regard to the abdomen.  You are a witness to several of these changes.  Yes, your skin has genuinely lost elasticity, evidenced by its overall looseness and stretch marks.  You also have some slight residual abdominal wall muscular weakness.  Finally, there is a given amount of unwanted fat present as well.  Realistically, laser liposuction could greatly improve the issues of skin looseness and unwanted fat by at least 60% or more improvement.  I would not recommend a tummy tuck just yet, given your age and your desire to have more children.  At this point, a comprehensive laser liposuction procedure by a competent cosmetic surgeon would greatly improve your abdomen's appearance... and it is important that you remain realistic.