I would like to know if this roll on my stomach is fat or excess skin? (Photo)

Thank you for your question and for sharing your photos and history.

Based on the provided information and the absence of stretch marks or extensive sun damage, the roll appears to be excess fat rather than skin, especially considering its softness upon pinching. Given your age and skin condition, I recommend abdominal liposuction to address this issue.
After liposuction, your skin, devoid of visible stretch marks, should retract well. Please adhere to postoperative care, including wearing a medical-grade compression garment and initiating lymphatic massages two weeks post-procedure.
I hope this clarifies your concern regarding the nature of your abdominal roll. Good luck on your journey!
Sincerely,
Dr. Katzen

Dear alonna1991,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Just based on your photos, you may have some excess fat and skin. An examination can tell. Liposuction can be done to remove excess fat and Renuvion can be done to tighten the skin.

It's difficult to tell from your photos if you are bending over or standing straight. It appears the area that concerns you may be both fat with a little excess skin. You can consider liposuction to address it and potentially add J Plasma to help improve any skin laxity. See a board certified plastic surgeon near you to learn more.

With a physical exam, you can usually tell if lipo will break up the fold and remove the fullness or if something more invasive is needed. A consult with a BC Plastic Surgeon will tell the tale.

It appears that your upper abdominal roll is a combination of both fat and skin. Liposuction of this area usually fixes the vast majority of this issue. Rarely do you require skin removal.

Erskine envelope is attached to underlying layers with series of connective tissue bands throughout the body. In some areas skew laxity has great mobility, because there are less connective tissue bands anchoring the skin in place. The upper inner thigh is such an area. In comparison, the back of the buttocks tends to have a lot of connective tissue fibers skin and this is one reason why cellulite cans to form on the back and back of the buttocks. Many people have a row of connective tissue fibers that anchors to skin in place across their mid back. As patients develop skin laxity due to loss of skin elasticities from age or from weight fluctuations it’s common to develop a back bra roll skin fold. On some people this row of connective tissue anchoring the skin to the torso continues on the from side of the torso. The position is usually at the upper abdomen lower chest interphase. Typically as skin laxity get worse either from age or weight fluctuations the fold becomes more defined. Typically the weight of the breast pushes down on the skin which will then fold at the line of connective tissue attachments creating the upper abdominal skin fold in sone individuals. This is difficult to correct with any procedure other than a sufficient tummy tuck at which time the skin and fat layers are separated from the underlying muscle facia potentially severing or cutting these connective tissue bands freeing the skin and fat layer reverting the fold from happening. Having a tummy tuck does not guarantee the release of these bands unless the surgeon recognizes the issue and purposely undermines(separating tissue layers) up to and beyond the level of these connective tissue bands. In a standard tummy tuck not all surgeons undermine to this extent. For anyone with this upper abdominal skin fold contemplating having a tummy tuck it is very important to confirm the surgeon has a clear understanding of the underlying cause of the skin fold and is specifically planning on undermining up beyond the row of connective tissue bands. The only alternative treatment is a reverse tummy tuck which is generally not a common or high patient satisfaction procedure.
The skin fold is not related to fat distribution and liposuction is not a good or appropriate treatment option.
If consulting with plastic surgeons make sure providers have a clear understanding of the etiology and clear understanding of treatment options that work including the ability to show you before and after pictures of previous patients who had similar body characteristics with successful outcomes.
Best,
Mats Hagstrom, MD

Hi. Generally speaking, if the skin is hanging down significantly when you are standing straight, then you have extra skin that needs to be cut out. But in cases like yours where the skin is not hanging much when you are standing straight, then it's extra fat. The fold you are seeing is due to the tethered skin in that area and the excess fat above it.
So in your case, I would just liposuction your abdomen and break up the area that is tethering down your skin. Keep in mind that liposuction on its own will cause some skin contraction.