2nd Tummy Tuck Needed for Failed Muscle Repair - Best Method?

asked 1 year ago by crazylegs
Latest answer by Thomas Fiala, MD
Question viewed 1,490 times
Tags: muscle tightening, technique

I had a full tummy tuck 3 weeks ago. I have never seen a completely flat abdomen. I took pictures at 2 days post op and there was a slight bulge above my belly button. At my 2 week post op PS thought that I might have a failure of the muscle repair but to wait until my 6 week appt to re-evaluate. My question is what is the best way to correct the bulge? A second full tummy tuck? Endoscopically? After a FTT how far should my belly extend when I am pushing outward?

10 answers to 2nd Tummy Tuck Needed for Failed Muscle Repair - Best Method?

Residual bulge after tummy tuck

As you have heard, a bulge can be from several different things in the early post-op time period. It could represent swelling, a fluid collection (seroma, etc.), residual subcutaneous fat, fascial relaxation with intact sutures, or suture breakage / pull through. The most important thing you need is a correct diagnosis, which is not something I can tell from your photos. You may benefit from a CT scan to check things out, if physical diagnosis is not clear. The correct... more

Thomas Fiala, MD
Altamonte Springs Plastic Surgeon

Upper abdominal fullness after abdominoplasty

First off you should not attempt to push outwards. It is in your best interests to perform core strengthening. In regards to your upper abdomen, it could be due to several causes, In many instances, it is fat which can be removed at a later operation and should probably NOT be removed at the initial operation due to concerns with the blood supply to the lower abdominal skin. Diagnostic imaging may help determine the cause of the fullness.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Bulge after a tummy tuck

The cause of this must be determined first. It can be simply swelling in the tissue, or residual fat above the umbilicus, or fluid trapped under the skin (seroma), or maybe a muscle repair problem. An ultrasound can help determine which of these is the culprit. Probably a muscle repair problem would be the least common as long as you went to a very experienced plastic surgeon.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

What to do about Persistent above Belly Button Bulge after Tummy Tuck?

Regarding: "2nd Tummy Tuck Needed for Failed Muscle Repair - Best Method? I had a full tummy tuck 3 weeks ago. I have never seen a completely flat abdomen. I took pictures at 2 days post op and there was a slight bulge above my belly button. At my 2 week post op PS thought that I might have a failure of the muscle repair but to wait until my 6 week appt to re-evaluate. My question is what is the best way to correct the bulge? A second full tummy tuck? Endoscopically? After a... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Bulge after a tummy tuck

The key thing is to figure out what the cause of the bulge is? Is it swelling, is it a fluid collection, is it a hematoma, is it a weakness in the muscles. An exam may help determine this and then you can go from there.

Steven Wallach, MD
Manhattan Plastic Surgeon

It pays to wait before revising an abdominopalsty

Three weeks (even 6) is too soon to consider secondary surgery after an abdominoplasty. It takes time for the swelling to go down and chances are you may not need a second surgery. I would not consider it for at least 3-4 months. If the problem persists, there are several choices and I would explore them all with your surgeon. Consider: a muscle tightening suture that broke not enough tightening (sometimes a horizontal tightening adds to the vertical one)... more

Lori H. Saltz, MD
San Diego Plastic Surgeon

Post tummy tuck bulge

The best advise is to follow up with your surgeon to express your concerns. There is no best way,only choices. Perhaps it may improve with time to some degree to make any revision less aggressive. Hope for the best but don't lose hope. Your surgeon knows all of the options for you to consider.

Timothy Fee, MD
Jacksonville Plastic Surgeon

Wait a bit before revision surgery

I have to agree that waiting a bit will be helpful. I have had several appear as you do, and most look much better as time goes on. This upper area has usually undergone some liposuction so it may have more swelling, and it can also trap excess fluid. With time alone it might go down. If it is due to fluid I have sometimes had to drain it out with a needle. Suture failure is usually not the issue, since the sutures are very strong. If your fascia (the gristle on top of the muscle where... more

Victor Au, MD
Chapel Hill Plastic Surgeon

Repairing failed muscle repair

It is too early to predict what if anything will need to be done. I would recommend waiting to see how you heal. Only then can you plan you revision, if necessary. Depending how the muscle was tightened, you may need to have the entire repair re-done. In such a case the entire tummy tuck area will have to be opened up to expose the muscle repair which then needs to be revised. Sincerely, Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon

Tummy tuck

Perhaps. some of the sutures, holding your muscles together, broke. I agree with your plastic surgeon. if things don't improve in the next several weeks, one could enter the umbilicus incision, and repair the problem, if it exists. Good luck.