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Upper Abdomen Much Bigger 4 Months Post-Op- Why?

hi i had a tummy tuck 4 months ago. and now my stomach is bigger, at first it wasnt big and then all of a sudden it got bigger but in the upper abdomen. and the lower left side is bigger then the lower right side. i was wondering is their any type of test i can do to see if the stitches poped or something? i asked my doctor but i really dont believe him he said its fat underneath my muscle and no more lipo can be done. and that the bottom part is my muscle but i really dont believe him. ;(

Doctor Answers (5)

Tummy Tuck - Upper Abdomen Much Bigger 4 Months Post-Op- Why?

+2

There are several possible reasons and it usually comes down to the anatomy.

First, it can be difficult to achieve a totally flat upper abdomen.  In many patients, there is inherent fullness in that portion of the abdomen due precisely to what has been suggested - excess intra-abdominal fat.  This cannot be corrected during a tummy tuck and when this is the case the most important aspect to be discussed ahead of time is which expectations are realistic - if that area cannot be made as flat as the lower part, or as you'd like, then that's something you need to know before you proceed with the surgery.  You may still want to, or you may not.

Secondly, it could be due to ruptured sutures of the muscle repair, or incomplete repair.  My feeling, in general, is that there is not as much that can be done with sutures in the upper abdomen as many patients wish there could be; you just can't pull the whole upper abdomen tight enough - and maintain it - with some stitches.  If there is a hernia or another aspect of the anatomy that can be repaired, that may change things.  At least a bit.

Finally, you have be sure there isn't fluid there (a seroma).  It sounds unlikely, but it's possible.  My guess is that it's related to your pre-op anatomy and, assuming your surgeon did "the usual" procedure, it's been corrected as much as it can be.

But, to investigate further, you may want to consider a few more surgical opinions.  Try to obtain and take along your pre-op photos so that the surgeon can have some perspective, as well as the operative report, so that what was done will be clear. 

I hope that this helps, and good luck,

Dr. E


New York Plastic Surgeon
5.0 out of 5 stars 145 reviews

Bulging after tummy tuck.

+2

Bulges in the upper abdomen following a tummy tuck often are the result of an incomplete approximation of the muscles above the belly button. We check for this in the office by having you lie flat while lifting your feet and head off of the table. This puts those abdominal muscle to work and allows for direct examination of the space between them. Your surgeon is correct that if you have too much intra-abdominal fat, no liposuction is going to correct that. However, you sound as though you no longer trust your surgeon's opinion. In that case, I would recommend seeking a second opinion.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 8 reviews

Uppe abdomen bigger after surgery

+2

as to the left lower side being bigger than the right, can be due to edema of the tissue under the skin from the raising of the flap. Usually over 1 year that smooths out but a little liposuction in that area is not uncommon to do. As to the upper abdomen being bigger, there are potentially 2 causes. the first is that since that area cannot be defated too well during the tummy tuck, there might be more subcutaneous fat there than on the lower abdomen, making it look large. The more common cause is that as the tummy tuck cannot change the amount of fat inside of your abdomen, when the muscles are tightened, that can put pressure on that fat compartment. The lower abdominal muscles are much easier to tighten than the upper ones near the stomach. So what can happen is as the muscles are tightened, the lower abdominal pressure is tighter and it make the fat inside of your abdomen push upwards and place greater pressure on that area than existed before. That can usually only be corrected with either weight loss or more sutures in the muscle, but if there is too much intra-abdominal fat, the muscles might already be maximally tightened.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 reviews

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Bulging upper abdomen after tummy tuck

+2

The most common cause of an upper abdominal bulge after tummy tuck is an incomplete repair of the muscle in the upper abdomen. If your doctor is not connecting with your concerns and questions, you may need another opinion to help sort things out.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Tummy Tuck Results?

+2

Thank you for the question.

You may be able to assess the integrity of the abdominal wall muscle plication by  flexing at the waist (diving  position)  while palpating he upper abdominal wall area. If there is significant laxity/bulging in this area when you press inwards you may be dealing with abdominal wall laxity as opposed to superficial adipose tissue.

It is somewhat unfortunate that you “don't believe” your plastic surgeon;  if this remains the case a second opinion by a well experienced/ethical  board certified plastic surgeon may be indicated.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 680 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.