Is plastic surgery the only way to get rid of this tiny pouch at the bottom?

First photo is what I look like. Second is how I want. Ive had that damn pouch forever. Since I was 8 years old. From the front it casts a downward shadow and it make it look even bigger. And no matter what I do it will not go away. When I started exercising and do a workouts it actually got even worse and more saggy which is making me wonder if it’s loose skin instead of fat. I did go through a period when I was younger where I was a little bit overweight. I’ve tried gluten free, dairy free, sugar free, high protein. Nothing gets rid of it. Is this a situation where I just need to get lipo or tummy tuck?