There are four variables that determine what someone’s abdomen looks like. Choosing the correct procedure should be based on having a clear understanding of what the problem is. Before variables to determine what the abdomen looks like our abdominal skin, laxity, access, subcutaneous, fat, muscle separation from previous pregnancies and exes, visceral or intra-abdominal fat. Muscle, separation and skin laxity are usually due to previous pregnancies and the correct treatment for those is usually a full tummy tuck. If someone does not have muscle separation and has a bulging abdominal wall, and there’s generally indicates the presence of excess visceral fat. Visceral fat can only be reduced with weight loss and will not be improved with either Liposuction or cool sculpting. Cool sculpting is generally an ineffective way to reduce subcutaneous fat. Based on your picture, it does not appear that you have thick layers of subcutaneous fat, but I have a bulging abdominal wall. If you don’t have previous pregnancies, then most likely, visceral fat is the culprit and weight loss is the only option to get a flat abdomen. Best, Mats Hagstrom, MD