Six-pack abs are related to how much you work out and how defined your abdominal muscles are. You can get them, but with a lot of work. If there is fatty tissue covering them, you will not see them. You have to get really thin, with no fat layer, in order to look sculpted. There are special diets that help you to lean down in order to get that appearance of muscle sculpting; however, for most people that’s not really a lifestyle option. Doctors can do liposculpting in order to get something that looks like a “six pack,” but, in my opinion, it does not look natural. If we remove enough fat to show the abs in sculpted layers like when in training, the skin will adhere to the muscle and will look unnatural. I don’t recommend removing that much fat with a surgical procedure. It will heal in an unnatural-looking way. I’m a physician not a magician. I can’t wave a magic wand and change someone who’s chubby into a lean lanky person.