You can usually tell how much subcutaneous fat you might have by grasping and rolling skin and fat together with two hands. You may have to slump forward to keep the skin loose enough. If you are able to grab these layers, and especially if you can slide the whole thing up and down, you're holding external fat. The fullness that doesn't move, that is deeper than the layers you are holding, is the abdominal wall. (Clench your abs to be sure.) This group of muscles contains the internal or visceral fat. If most of your fat is external, rather than internal, you can have it removed by surgery or nonsurgical methods. Surgery could include liposuction and or abdominoplasty. CoolSculpting is our preferred nonsurgical method.You are correct that plastic surgery cannot remove visceral fat. A final consideration is abdominal wall looseness. Some abdomens are relatively firm and won't change much with deep muscle tightening, while others improve dramatically with suture tightening during abdominolasty. "Sucking in your stomach" can give you some idea of the amount of change possible. After you've made your own diagnosis, consult an experienced board certified plastic surgeon and seek his or her opinion and recommendations.