Tummy tuck, 18 months post op - hard pooch in lower abdomen. Should I be concerned? (photos)

Phoenix2288, it would be helpful to know if you had muscular tightening (plications). You may have laxity in your muscular wall which may need to be fixed. This also may be a herniation, especially if you noticed the bulge after activity such as lifting something heavy. Another possibility is a fluid collection know as a seroma which would need to be drained. I recommend you follow up with your surgeon for further evaluation as they can do a thorough examination. They may find imaging such as ultrasound to be helpful in this scenario to determine the cause. Hope this helps

Your photos did not show your scar or the "muffin" so I would go back to your surgeon and discuss your concerns.

Thank you for your question regarding a tummy bulge 18 months after a tummy tuck. It appears that this bulge is from the pubic region to the umbilicus. With a person of your body build with minimal body fat and minimal excess skin, this could only be muscle weakness. To be sure, I would suggest a pre-operative MRI. I am pretty sure that this will establish an area of muscle weakness. If it is, I suggest an incision be made in your prior tummy tuck scar and dissection be carried to the umbilicus or even the sternum. Your rectus abdomonis muscle needs to. Be reevaluated. If the muscle is weak, your rectus needs to be tightened with a permanent suture. I would do this from the umbilicus to the pubic region. In addition, if this upper abdomen is weak or lax, I highly suggest muscle plication from the sternum to the umbilicus. Thank you for your question regarding a tummy bulge 18 months after a tummy tuck.
If you have any more questions regarding the tummy tuck or abdominoplasty, please contact my office. Since an abdominoplasty can be a difficult procedure, please seek an experienced, board certified plastic surgeon with significant experience performing tummy tucks. Do your research. Make sure your chosen plastic surgeon has performed at least 100 abdominoplasties. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Good luck! Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)