Fat pockets on lower stomach - how to make flat/smooth? (Photo)

I have a pouch of fat that is on my lower abdomen. I run and do abs and no matter how thin or if I put on a few pounds, it is there. What's the best treatment for this? Is surgical necessary? What do you recommend.

Doctor Answers 17

Fat pockets on lower stomach

Great question!  The lower abdominal regions is a very stubborn area where fat likes to accumulate.  Looking at your photos, you have several options. non-surgical or surgical, and each has its advantages and disadvantages.

Non surgical options include Coolsculpting which "freezes" the fatty tissue.  The advantages are that its quick, there are no scars, and you sit in a chair for an hour each treatment.  However you do not see immediate improvement, it takes about 4-6 weeks for the fatty tissue to be metabolized, and the final results are not as drastic as liposuction.  You may need a second or third session to achieve your goals.

Surgical options would include liposuction.  The advantages of this is that fat is physically being removed during the procedure and the surgeon is able to contour the region, giving the surgeon more control over the final results.  More fatty tissue can also be removed with this procedure and generally is all done in one sitting.  However, it is a surgical procedure so you may need to be placed under anesthesia, and the recovery is more painful.

Therefore, in your situation, it depends on what fits with your goals and lifestyle.  A more in-depth discussion can be performed with a consultation and physical examination.   Best of luck and hope this information helps!

- Dr. Roger Tsai

Beverly Hills Physician
5.0 out of 5 stars 11 reviews

Fat pouch on lower abdomen

Thank you for your photos. Many people have a persistent lower abdominal "pouch" which just never goes away regardless of diet and exercise. It appears you have minimal excess skin and would be a good candidate for liposuction to remove the excess fat. It is always best to have an in-office examination to determine the exact causes of your appearance. If you do have excess skin and your abdominal muscles are also a bit lax/stretched, then you would benefit from a mini tummy tuck which would remove both excess skin and fat while tightening your abdominal muscles. This would leave a lower abdominal transverse scar which is hidden in your underwear or swimwear. Hope this helps!!

Johnson C. Lee, MD Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Abdominal Pouch

Thank you for  your photos and I appreciate your concerns.

Although there are nonsurgical techniques for permanent fat reduction the question is what degree of improvement you are hoping to make.

Vanquish ME is an excellent device and can reduce both the upper and  lower abdominal fullness over a 2-3 month period. The device uses radiofrequency to heat the fat and cause permanent damage to the cells. The body then clears those cells away. This can make a very  nice improvement nonsurgically.

If you want a more dramatic result. Liposuction is a very good technique for you as your skin tone is good and it does not appear the abodminal muscles are lax. Incisions are small and placed in cosmetically silent areas. You will have to undergo anesthesia and recover while wearing a compression garment but the degree of reduction of fat and the final contour will be significantly improved.

Seek out a board certified plastic surgeon to evaluate you and discuss which of these options is best for you.

Good luck and I hope this was helpful

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
4.9 out of 5 stars 121 reviews

Fat pockets on lower stomach - how to make flat/smooth?

Thank you for your pictures and questions. The best treatment for you depends on your ultimate goals and expectations. If you are looking for minimal improvements with no surgery, there may be some non-invasive options for you. If you are looking for more significant improvements, then liposuction may be an option. If you are looking for a recontouring of your abdomen, then a small tummy tuck may be in order.

Best to have a consultation with a local board certified plastic surgeon and discuss your goals in detail. Only after that can you decide what procedure would be right for you.

Best of luck!

Smoothing and flattening fat pockets on lower stomach.

You need a face to face exam and consultation however from your photos you appear to be a good candidate for liposuction of your stomach. This will improve and flatten your stomach wall but not leave it perfectly smooth and perfectly flat due to your natural stomach contour and the lax skin that will remain behind.  I think that the procedure is very worthwhile but your expectations should not exceed what can realistically be accomplished.

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews


Hi there! If exercise and dieting doesn't improve the fat around your lower abdomen, then I would recommend liposuction to target the fat. As always, please seek an in-person consultation with a board-certified surgeon. I wish you the best of luck!

Peter Newen, MD
Orange County Plastic Surgeon
4.3 out of 5 stars 19 reviews

Fat pockets on lower stomach

Looks like you are a great candidate for liposuction.  Liposuction is ideally used for stubborn areas of fat that are difficult to remove with diet and exercise alone, and with good skin tone.  Would need to examine you to get a better idea of your skin tone, but from these pictures it appears that you qualify.  Hope that helps -

Lower abdomen fat will not go away

Thank you for asking about your lower abdomen fat pouch.

  • This is frustrating for you and there is an answer although it will be surgical.
  • if the 'fat pouch' is fat - liposuction will remove it.
  • If the 'fat pouch' is also from an inhterited lower abdominal muscle diastasis (widening)  - which can be inherited - the answer is muscle tightening and liposuction.
  • You do need to see a plastic surgeon for an exam and advice as to which is the better approach for you.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Nothing beats liposuction for that great tummy.

Liposuction would really make a big improvement in your tummy and is so easy to undergo under tumescent local.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.8 out of 5 stars 37 reviews


Hello. From the posted photos you appear to be a good candidate for liposuction of the abdomen and flanks. The procedure is ideal for diet and exercise-resistant fat deposits. 

Good luck 


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.