Stomach Bulge After Tummy Tuck and Liposuction

Question

I had Tummy Tuck with MR and Liposuction on the bra rolls, flanks, gluteal fold, and banana rolls on December 4th. When I stand, my stomach is flat, but when I sit, I have a roll. Is this because I have a short waist or is it from the Liposuction? My fear is that I will need a revision.

Armando Soto, MD, FACS · Answer

Hi there-
The situation you describe is quite common and is not necessarily indicative of a problem. If your abdomen is flat when you are standing, and you have a pleasing contour, but you see some fullness when you sit, this is more likely an indicator that your skin has simply lost some elasticity (which you already knew, and is no doubt one of the reasons you were having a tummy tuck).
When a young person, with excellent skin elasticity sits down, the skin contracts (because it is elastic), but if the skin has lost some of this quality through pregnancy or weight gain and weight loss cycles, it will not be capable of this contraction in the sitting position, and the skin will appear a bit redundant.  It's really a skin QUALITY issue, not a skin quantity issue.   I would visit with my plastic surgeon to make sure something else isn't going on, but it sounds like you have a very nice result. Congratulations on your new contour!

J. Timothy Katzen, MD, FACS · Answer

Congratulations on undergoing your tummy tuck procedure! It sounds like you've had a successful surgery, especially since your abdomen appears tight when standing. The presence of a roll when sitting could be due to several factors, including your individual anatomy and skin quality.

Based on your description, it seems like you may have more of a skin laxity issue rather than a skin quantity issue. It's not uncommon for the skin to take some time to fully adjust and settle into its new position following surgery. I recommend giving it a bit more time to see how your results continue to evolve.

Typically, it's advisable to wait at least 6 months post-surgery before evaluating the final outcome of your tummy tuck. During this time, your body will continue to heal, and any residual swelling or skin adjustments may resolve naturally.

If you still have concerns about the appearance of your abdomen after this period, I encourage you to schedule a follow-up appointment with your plastic surgeon. They can assess your progress, address any lingering issues or questions you may have, and discuss potential revision options if necessary.

Overall, patience is key during the recovery process, and it's important to maintain open communication with your surgeon throughout your journey. Wishing you continued success with your tummy tuck recovery!

Sincerely, Dr. Katzen

Otto Joseph Placik, MD · Answer

It is difficult to assess why you would have a persistent roll when sitting after tummy tuck and extensive liposuction, It may be: 1) conservative skin removal, 2) need for more liposuction, 3) recurrent skin laxity, 4) excessive liposuction with skin laxity, 4) retraction of SFS repair with tethering of scar to rectus fascia and resulting shelf like deformity, 5) a low umbilical inset with gathering of tissues beneath this area 6) short waist with costal margin impinging on iliac crest, etc

David Shafer, MD, FACS · Answer

Libraldy23,
It is hard to give you any specific advice without any pictures or timeline for the procedures that you had.  Naturally, when you stand or lay flat, your abdomen is going to be stretch out and, thus, flatter.  When you sit up it will be looser.

Jeffrey Zwiren, MD · Answer

It is possible that you may eventually need some touch up liposuction but overall your result looks good.  You are still early in the healing period given more time these features may resolve.

Pat Pazmino, MD, FACS · Answer

A tummy tuck is a very popular and effective way to contour the abdomen. In our practice, we design each tummy tuck to fit the individual patient. Patients who receive this procedure should anticipate a significant recovery process that can include bruising and some swelling. For this reason, we provide all of our tummy tuck patients with two garments that will help them manage their swelling. If after your swelling has subsided and you continue to notice a stomach bulge above the belly button after your tummy tuck, you may have experienced a loosening of the muscle repair. You should return to your plastic surgeon with these concerns for an examination, they can determine whether this bulge is from a loosening of the muscle or a pocket of fat. Either way, a small revision tummy tuck can address these concerns are it

	To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Peter A. Aldea, MD · Answer

Without a photograph it is impossible to accurately guess at what you are seeing. But it is clear that at 1 month after the surgery it is WAY too soon for you to panic. It takes months for swelling to go down and finally resolve and I am sure the results in a few months from now will be much better. (This is providing you watch your diet and do not put on weight).
Discuss this with your Plastic surgeon and agree to look at things 6 months from your surgery and agree on what to do about it - if anything - then.
Dr. P. Aldea

Steven Wallach, MD · Answer

If your stomach appears flat when you stand but is slightly rippled when you sit. It probably is normal. The skin has to roll a bit when you sit because it is on maximal stretch when you stand. Some of the concerns of a roll may disappear with time as the final swelling goes down. This of course means that you weight is stable and you have not gained any weight.

Stephen A. Goldstein, MD · Answer

As you are aware the tummy tuck procedure involves tightening the muscle/fascial layer which flattens the anterior abdominal wall.  Additionally, when the fat/skin layer of the abdomen is cut out (excised), it is removed in an oval shape.  The middle portion of the excised fat/skin layer which is directly above the pubic area is very tight, whereas, in contrast, the ends of the incision near the flanks the skin is loose.   The fact that in the standing position, you recognize that your abdomen is flat is a great sign.  We all have loose skin when sitting and flexed.  Be patient and give it more time as your results will steadily improve. But in the worse case scenario, a small touch-up procedure may be required.
More than likely your surgeon talked and informed you prior to your tummy tuck and liposuction procedure about the potential need to perform additional procedures and revisions. Your treating plastic surgeon knows you the best&hellip;knows your anatomy&hellip;and, knows the operation he performed on you.  I would strongly advise you to go back to your plastic surgeon and discuss your issues with him/her.  I am sure that with time your results will continue to improve.  
Stephen A. Goldstein, MD

Robert M. Freund, MD · Answer

You have had a lot of surgery and are most likely extremely swollen. Do not judge your results until the swelling is gone! In addition, you should judge the results in the standing position. Everyone has a roll when they bend over!

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