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.

Hi,
Thank you for the question.
Based on your photos, you are a great candidate for a mommy makeover surgery. If you want to primarily focus on your abdomen, I would recommend a fully tummy tuck and liposuction of your abdomen and flanks, to help create the hourglass figure,
Tummy tuck would allow to remove the excess skin below the belly button and to tighten the recuts (abs) muscle in order to achieve a flat abdominal contour.
I would recommend an in person evaluation by the Board-Certified Plastic Surgeon to evaluate the thickness of your skin and status of your muscles
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

From your photograph, you have excess skin that is hanging as well as fat. The technique I recommend is abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Dear Courageous4621,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your photo and questions. During a tummy tuck the excess skin from the level of the belly button down to the hip bones is removed. Skin above the belly button is pulled down. Abdominal wall laxity is also corrected. Liposuction is typically not performed on the abdomen during a tummy tuck, but many patients to elect to have the hips/flanks suctioned to enhance the tummy tuck results.

You should consider both an aggressive liposuction of your sides and lower back combined with an aggressive abdominoplasty. Your upper abdomen has both fat and skin. The fat cannot be liposuctioned at the same time as your abdominoplasty because it may compromise the blood supply to the skin flap.
I'm not sure that 1 liter of fat from your side and lower back liposuction is enough.
Dr. Taranow

You did not specify exact surgeries planned? But it is obvious you are having surgery in Florida, because of the Florida Boarded of Medicine office surgery rule limiting combination office surgeries to ONLY 1 liter (2.2 pounds) of liposuction. Based upon your posted 1 photo you need an extended TT with the allowed 1 liter lipo (which is NOT enough lipo, BTW). If doing in hospital surgery the rule does nt apply to 1 liter. Maybe you need to see your assigned operative surgeon first or via virtual to be examined and a discussion upon the possible need for multiple surgery rounds/stages.

Hello and thanks for your questions. Based on the information that you have provided and your story, I can clearly say that the reason that you have sagging tissue on your tummy is only because of the fat tissue you have around your belly button. After massive weight change, aging and the pregnancy, It is very possible to have an sagging tissue on the tummy area. This is very related to the skin quality. Based on your pictures, the perfect treatment plan for your case will be tummy tuck together with the liposuction. Tummy tuck is performed for removing the excess skin and repair the stomach muscles. In addition to that liposuction procedure is performed for removing the extra fat tissue around your tummy and flanks area to achieve the slimmest body structure as possible.