Getting a mommy makeover - stomach is round over my belly button. How do I know if it's fat or skin? (Photo)

A tummy tuck is an aesthetic surgical procedure to improve the shape and appearance of the abdomen. During a tummy tuck, excess skin and fat are removed from the lower abdomen. The upper skin and fat are lifted off the abdominal wall above the belly button to the lower sternum, and the central portion of the abdominal wall is tightened. The remaining skin is then repositioned downward to create a more toned look. From your description and photo, there are several reasons why there might be 'roundness' of the belly button region - (1) excess fat, (2) excess skin, and/or (3) widening of the muscles that allow the region to bulge. A careful examination is required to help understand what is going on. It is helpful to place a finger in the belly button itself and feel where the abdominal wall is located. The base should be at the level of the abdominal wall. Is there a bulge? Is the abdominal wall easily pushed down? If there is too much weakness it may mean that your muscles have separated alot from childbirth and they never went back to the pre-baby position. Then you could take your second hand and push from 4 inches to the side of the belly button (the side border of the rectus muscle) and see how much fat is located between your hand and the finger in the belly button. This gives you some idea of the amount of fat. Lastly, you can see that the skin is very loose and drapes down. From this information, it is a good bet that your board-certified plastic surgeon knows that you will need each one of these components - skin, fat, and muscle laxity - repaired. The exact amount of fat is hard to judge just from this information, but it very clear that you are taking your next step to a better overall shape!

Hi Courageous4621,
The most common reason to have roundness in the central abdomen, especially after having 2 kids, is rectus diastases. Anatomically, 6 pack muscles usually sit vertically together in the midline, but this right to left connection can be weakened during pregnancy and/or weight gain. As such, patients with a weakness skin between the 6 pack muscles have a rounded appearance to the abdomen, as the intra-abdominal contents are able to bulge forward.
A tummy tuck does a number of things, including removal of excess skin and fat, typically below the bellybutton, liposuction of the hips and flanks, and tightening of the core muscles to alleviate rectus diastases.
Hope this helps.
Best,Christopher Pannucci MD MSBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

It's a combination of fat and skin. I think it is appropriate to have this conversation with your surgeon to ask what you can reasonably expect after surgery. I generally do more than 1 liter of liposuction with a tummy tuck.