Fixing Previous Tummy Tuck Results and Post-pregnancy Belly

Congratulations on your pregnancy. Usually we sort of hate to see the result of a good abdominoplasty come undone but in your case maybe not so much since you were dissatisfied anyway. Secondary abdominoplasty can be a very challenging procedure so I would suggest that you find a plastic surgeon who has a special interest and experience with this. The issue is not so much whether the muscles have spread again, but whether the skin stretches out enough to basically re-do the whole procedure. The skin above the belly button has to be able to expand all the way down to the pubic area. And making a nice belly button is a bit of an art form so ask specifically about that in consultation. You may have a hernia at the belly button so that shoud be evaluated too.

This is a great question to ask for all of those face torso appearance issues when pregnant after a previous procedure. Agreed that the little contouring with your procedure could be touched up later with liposculpting of your entire torso/core, or another cleaner abdominoplasty. This would likely provide better results for shaping and trimming and hopefully help meet the initial goals of final results that you had when entering this procedure. See a board certified PS to discuss a procedure and the final sculpting that may help you become satisfied.

It’s
virtually impossible to make a treatment recommendation until you’ve completely
recovered from your pregnancy.After
pregnancy you will probably have recurrent weakness of your muscles and
redundant abdominal skin as well. Under these circumstances you will
probably be an excellent candidate for a revision abdominoplasty.At that time muscle repair can be undertaken
to further tighten your upper abdominal wall and remove excess abdominal skin.It’s important to discuss your
situation with a board certified plastic surgeon with experience in this
area.This surgeon should be able to
formulate a treatment plan that addresses your anatomic findings and achieves
your aesthetic goals.

I can think of three likely scenarios to result in what  you describe: tight lower abdomen but bulging upper abdomen. This usually happens by either performing a "mini tummy tuck" that is only tightening the area just below the umbilicus  or else disproportional tightening the lower abdominal muscles more than the upper ones, or a dehiscence (repair came apart) on the upper abdomen. When the lower abdominal muscles are tightened this displaces the abdominal contents towards the top causing it to protrude. In general, most cases both the bulging and your belly button can be improved but without examining you I cannot answer for sure.

 

Larry S. Nichter, MD, FACS

I believe that a tummy tuck revisions is possible.
In regards to your belly button that is more difficult to say. Twin pregnancies are devastating to the abodminal wall causing umbilical hernia like conditions ("outie") that can be difficult to correct.
As has been previously suggested, obtain a copy of your operative report. A full tummy tuck may mean different things to differentl surgeons. The knowledge of your previous technique may benefit you and the next surgeon.
I have had occasion to perform tubal ligations and tummy tucks together. Perhaps you should request a referral from your OB-Gyne to a plastic surgeon with whom they have worked. They may be able to vouch for his/her results.
I hope all proceeds well and wish you the best of health in your delivery.