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Why Does My Belly Stick Out?

[fa icon="calendar"] February 28, 2018 / by Dr.J

There are some obvious, and some not so obvious reasons why your abdomen may stick out more than you want it to.  Let's take a closer look and see what can be done about flattening your tummy.

OK, lets get the more obvious thing out the way.  Fat that has collected under the skin will make the abdomen protrude.  From a Plastic Surgery point of view, fat can be removed with liposuction.  This involves making small nicks in the skin and injecting a fluid containing numbing medication and epinephrine.  The numbing medication makes the postop recovery easier and the epinephrine prevents blood loss.  Then, a thin metal wand is inserted to gently suction out the fat.  I use Power-Assisted Liposuction, which means the canula vibrates back and forth, allowing the procedure to be performed more gently, thereby reducing postoperative pain and bruising.

Liposuction relies on the skin to have good tone so it shrinks back well.  So, what if the skin has lost its tone?  If this is the case, liposuction can still be perfomed but it is recommened that the the loose skin be excised as well.  For example, we frequently combine liposuction with tummy tuck surgery.

Unfortunately, fat can also accumulate inside the abdominal cavity around the bowels and within the organs.  This is called "visceral fat" and is not amenable to surgical removal.  This fat would have to be lost with diet and exercise.

Not all protruberant bellies are caused by fat, however.  Because there is constant pressure within the abdominal cavity pushing outwards, any weakness in the abdominal wall will cause the abdomen to appear protruberent.  A very common example of this phenomenon is the rectus diastasis.


Rectus diastasis means that the rectus muscles that run up and down the center of the abdomen have separated. (see the above diagram - the image on the left shows the normal anatomy where the muscles are lying against one another.  In the image on the right, the muscles have separated).  This happens frequently after preganancy.  The weakened tissue between the muscles allows the abdomen to protrude.  It's therefore possible for very thin women to have a protruberant abdomen even if their fat content is extremely low.

Patients can check for themselves if they have a rectus diastasis by doing a "crunch" sit-up (meaning laying flat on your back and lifting only your head and shoulders off the floor). While you're doing the sit-up, if you notice a bulge in the midline, you would likely benefit from repair of the muscle separation.

Fortunately, Plastic Surgeons can repair the separated muscles.  In fact, this is routinely done during a tummy tuck.  Personally, I repair the muscles in the midline and add two rows of sutures on either side, thus flattening the tummy as much as possible and drawing the waistline in to create an hourglass shape.

Ready to procede with your body contouring surgery?  Book this month and take 15% off our usual fee.


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Topics: Blog


Written by Dr.J

Dr.Jeffrey Horowitz is a Board Certified Plastic Surgeon committed to his patients' health and beauty.