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Flabby and Fat Abdomen After Tummy Tuck

I had a full Tummy Tuck almost 3 months ago. I am in excellent health, don't smoke, never had children. When sitting, my belly rests on my thighs. When bending, my stomach hangs. When standing, my tummy looks fat and paunchy. I can pinch chunks of skin (fat?) above and below my belly button. Not tight at all. This doesn't seem normal to me after Abdominoplasty. My doctor says I'm near my final results and not swollen. He says I need Liposuction to eliminate the flab (fat), which I think may make my stomach look worse. Opinions or suggestions please.

Doctor Answers 4

Staged liposuction may be needed

Sometimes it is necessary to have an additional procedure such as liposuction after an abdominoplasty. We sometimes call these staged procedures. In your case your results look as if additional liposuction is needed. I would recommend that you visit your surgeon and ask him for his opinion.


Manhattan Plastic Surgeon
4.5 out of 5 stars 5 reviews

Your surgeon is probably correct...

Hi there-

Of course without examining you it is difficult to say for certain, but from the photos you posted and your description of your complaints, I think that what your surgeon told you is right on...

It sounds like the problem was with your expectations from your tummy tuck... even the best performed tummy tuck will not reduce the thickness of the fat on the abdomen, as this would require liposuction- which is generally NOT thought to be safe to do at the same time as a tummy tuck. The goal of the tummy tuck was to tighten your muscles and remove the excess skin- if there is fatty tissue in the thickness of your abdomen, this will need to be dealt with through liposuction- usually 6-8 weeks after the tummy tuck.

It also looks like you may have some fatty tissue collected inside your abdomen, where your intestines and other organs are (this is called visceral fat, as opposed to the subcutaneous fat that we remove with liposuction)- this is not possible to reduce through any plastic surgery, as doing so may endanger your organs and safety.

Go back to your surgeon, explain your goal, and follow his/her recommendations... I don't think there is a problem with your tummy tuck- you just need some liposuction to put the finishing touches on your result.

Secondary Treatment May Be Necessary

When plastic surgeons perform abdominoplasty, safety is always their first priority. For this reason, they sometimes make compromises that increase the safety margin and minimize the potential for complications. This might involve minimizing tension on wound closures to avoid wound breakdown or performing liposuction as a secondary procedure to avoid damage to the blood supply of skin flaps. For these reasons, it’s important for patients to have realistic expectations following this type of procedure. Sometimes a secondary procedure just can’t be avoided.
It’s difficult to make treatment recommendations without performing a physical examination. With that said your history and pictures demonstrate residual fat in your abdominal wall as well as minimal skin laxity. It’s important to realize that the skin always loosens when patients flex their abdomen when sitting or bending over.
Once healing is complete, you might be a candidate for liposuction or resection of additional skin. It’s important to discuss these issues with your plastic surgeon. Your surgeon should be able to formulate a treatment plan that addresses your concerns.

Possibly a second stage is needed?

Hello, It is possible that you may need a second stage to your procedure. There is a maximum amount of fat that is allowed to be removed in every state, which is why your surgeon probably didn't over do it. I would recommend you meet with your surgeon and see what he suggests. From the sound of it and your pictures you may need a second procedure of liposuction to remove fat and shape your torso. Best of luck.

Jaime Perez, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 48 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.