How can I tell if I have fat under my abs? I've read that Tummy Tucks aren't as effective with a substantial amount. (photos)

I am a 32 year old mother of four 9.5 lb babies (youngest is 2), I am 5'3" so those babies went straight out. I can feel a separation between my abs particularly at my belly button. Laying flat, my stomach flattens out pretty flat. I posted my pic previously and a couple of doctors seemed to think that maybe the fat under the muscle could be a possibility, that has me a bit worried. I hope to lose a few pounds before surgery.

Doctor Answers 9

Intra-abdominal fat and tummy tuck

You have asked an important question.  Its important to understand that everyone has some fat inside the abdomen surrounding the intestines.  This fat is not treated with a tummy tuck and, if excessive, can limit the benefit of the surgery to some extent.  The only way to reduce this fat is with weight loss although for some people it may take an unreasonable amount of weight loss to accomplish this.  Typically, men carry a proportionately greater amount of fat within the abdomen whereas women tend to carry more fat immediately beneath the skin.  Short of a CT scan we can only get a general sense of the amount of fat on physical exam but seeing how much your abdomen flattens when you lie down is a good approximation.  The flatter your abdomen the better candidate you are for a tummy tuck.

Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

Fat beneath Ab muscles

Thanks for the pictures. The only way you can tell if you have that fat below your abdominal muscles is through the examination. Based on your pictures you probably do have some fat below those muscles. This would not preclude you from benefiting greatly from a tummy tuck. Seek several others opinions.

Good luck.

Earl Stephenson Jr MD DDS FACS

How can I tell if I have fat under my abs? I've read that Tummy Tucks aren't as effective with a substantial amount.

    If you are close to your goal weight, the tummy tuck will give a nice result.    The amount of visceral fat can vary person to person.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

How can I tell if I have fat under my abs? I've read that Tummy Tucks aren't as effective with a substantial amount.

ALWAYS best to lose weight prior to TT operation. Yes, you might have visceral fat that can be lost in weight control... 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Influence of fat under the abdominal muscles on tummy tuck results

You are correct that even the best tummy tuck cannot compensate when there is intra-abdominal fat or fat inside the abdomen.

Based on your photographs you do have some intra-abdominal fat however the protrusion that you see is also influenced by the split in your muscles the diastases recti.  You not obese and should be a good candidate for a tummy tuck to remove the loose skin and repair your muscles.

I agree that a 10-20 pound weight loss will most likely reduce intra-abdominal fat and improve your results.

Assessing a patient as a good candidate for an abdominoplasty

You have some degree of intra-abdominal fat.  When evaluating a woman for an abdominoplasty four components need to be checked
  1. Skin
  2. Subcutaneous  fat
  3. Anterior abdominal wall laxity
  4. Intra-abdominal or visceral fat
You have a problem in all 4 of these areas but your intra abdominal fat does not appear to be excessive.  A ten pound weight loss will most likely eliminate this problem and allow you to get a nice result with an abdominoplasty.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

How can I tell if I have fat under my abs?

The photos look like you have quite a bit of fat behind the muscles. You can test for this yourself. Lie flat on a firm surface. If your tummy skin is above your rib skin (ie further up from floor level when lying down) you have too much internal fat. But you do have lots of indications for a tummy tuck and would benefit from one. You just can't get as flat a tummy as someone with less internal fat.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Tummy tucks to help with abdominal fat

Based on your photos alone, it looks like you would benefit from a full tummy tuck procedure. A tummy tuck (abdominoplasty) gets rid of not only the excess skin, but it also repairs the stomach muscles that separate during pregnancy and childbirth. You had mentioned that you could feel a separation, and this is what you are feeling. You more than likely do have some fat as most people do, however, much of your issue is probably due to the laxity of your stomach muscles after childbirth. I hope that this is helpful for you to decide what you want to do.

Mark E. Mason, MD
Dallas Plastic Surgeon
4.3 out of 5 stars 26 reviews

Everyone has some intra-abdominal fat


Yes, the more intra-abdominal (behind the muscles) fat there is the less likely that you will get a completely flat abdomen.  The curvature of the spine also plays a role since it will push out the abdomen.  Physical examination is the best way to evaluate how much intra-abdominal fat there is.  I suspect you will get a great result with a full tummy tuck and strong abdominal muscle tightening.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 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.