You should probably have surgery again.

This is a good question.

Very rarely after abdominoplasty (tummy tuck) the deep sutures break and need to be replaced. I see this in my practice in patients who went out of the country for surgery and then return back to New York with problems. We are then stuck in a situation where the patient had a surgery somewhere else that now needs to be fixed. From what you describe, I do not think that you need liposuction. If the sutures truly did break or loosen, then you need to have them replaced. You definitely do not need to have the surgery completely redone, but you do need the sutures replaced. This can be done through a much smaller area through an existing incision. Liposuction is sometimes combined with abdominoplasty but not for the problems that you have.

I hope this is helpful.

David Shafer, MD
Shafer Plastic Surgery - New York City

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It sounds like the buldge above your belly button is from the suture that repaired your muscles tearing.  This means that your abdominal muscles are no longer held together tightly in the middle, creating the appearance of a buldge.  This can only be corrected with surgery.  Liposuction can be an adjunct to this procedure to remove excess fat, but will not fix the cause of the problem.

Kari L. Colen, MD, NYC Plastic Surgeon, colenmd.com

It sounds like you are describing the tearing of a suture to repair a diastasis recti. Diastasis recti is a problem of the abdomenal wall muscles that typically occurs after childbirth, whereby the space between the muscles in the midline spreads apart causing a bulge and loss of your hourglass shape.

During a tummy tuck, your plastic surgeon eliminates the space by placing sutures that pull the muscle together from either side of the separation. The result is a flatter, tighter abdomen with a nicer overall contour. The tear that you describe can only be fixed by replacing the sutures.

You do not have to undergo a repeat tummy tuck. Plastic surgeons can place those sutures using endoscopic equipment through a small incision in your belly button. The alternative suggestion of liposuctioning the bulge is not a satisfactory option in my opinion because you are ignoring the problem, not treating it. Get the problem fixed correctly!

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Worried,

It is relatively early in your recovery from surgery.  I would wait at least 6 months and during that time get back to your normal daily routines, work activities and exercise regimens.  You can then see how the muscles redistribute their activity.  I have seen such bulging from presumed ruptured sutures flatten over time.  Although it may not completely resolve, it may improve to the point that a little touch up liposuction may be all that you need, if anything at all.  Good luck!

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If the lump is from the upper plication sutures that tore, then replication is required.  If it is just some fat that is part of the upper flap then liposuction can help the area. 

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