18 Days Post Full Tummy Tuck and Have Huge Love Handles, Is this Part of the Swelling? (photo)

Question

Well..Where do i begin..Have to say this probably has been the longest 18 days ever...Im finally feeling back to normal No pain at all..:) can sleep on my side can bend over but still taking it very slowly can walk stand up just back to normal life again.The only thing is im Unhappy with my tummy tuck..Yes i was fully aware it wouldnt be perfect an i would still have some work to do.But im left with huge love handles an the top of my belly doesnt feel tight anymore scar is so high on my hips :(

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	You are correct in that there will be undoubtably some swelling left at this stage in your recovery. However, I am concerned that you will continue to have a significant amount of excess skin/adipose tissue in the " muffin top&rdquo; area.

	Treatment of the stubborn muffin top involves excision (lipectomy) of excess skin and adipose tissue.  This can be done as part of an &ldquo;extended tummy tuck&rdquo;. Liposuction  surgery alone  will potentially leave you with loose skin and an  unsatisfactory result.

	Patients who are undergoing a standard tummy tuck procedure  should be aware however that often an &ldquo;extended&rdquo; tummy tuck is necessary to treat the muffin top area. This extended tummy tuck procedure involves flank and back skin and adipose tissue excision as well as liposuction surgery. If liposuction alone is done the patient may still end up with the muffin top and require further surgery to improve the waistline in the future.

	At this point, I would suggest you continue follow-up with your plastic surgeon.  evaluate the end results of surgery one year postop to determine if additional skin excision and/or liposuction surgery  will be helpful.

	Best wishes.

Kenneth Dembny, II, MD · Answer

Based upon the photos you provided it appears that you have experienced nice improvement in the anterior abdomen &ndash; your stomach is much flatter, excess skin has been removed, and your umbilicus looks better. Only two and one-half weeks after surgery has passed, and you can expect to have moderate swelling at this point. It will probably take three months or more for your most of the swelling to resolve.

	However, you should have been offered liposuction of the flanks (love handles) and lower back at the time of your tummy tuck. This would have improved your contour and results; and when combined with an extended tummy tuck the excess skin in this area would have been removed as well. It appears that your surgeon attempted to do this, in part, by using an extended approach. But more was required, and unfortunately you see that now.

	It is important that you address this with your surgeon at your next visit. For now it is important to wait at least 6 months, for the swelling to completely resolve, before considering any revision surgery. I do not think you will be happy with your current result, as I do not believe the overall shape and contour will change significantly &ndash; but it is still important to wait. You will likely need liposuction and additional skin excision, the extent of which can only be determined after all swelling has resolved and final healing has occurred. Liposuction will produce additional skin laxity in this area, and that will allow your surgeon the opportunity to lower the scars on your hip &ndash; a benefit given the lo-rise style of pants you wear. To do this, your scars will be longer, extending further posteriorly; but the improved contour should make it worthwhile. You and your surgeon should be able to work through this to achieve the result you desire.

	Best wishes, Ken Dembny

Richard H. Tholen, MD, FACS · Answer

Hi, Lynn. You are not even 3 weeks from surgery, so you do indeed have swelling in your hip rolls where less skin was removed. These "dog ears" can result when the loose skin extends past the front of the abdomen into the hips, lateral thighs, and buttocks, but the surgery did not! Whether you call this area of residual skin laxity "love handles," "dog ears," or "muffin tops," at some point where the skin incisions stop, all of the loose skin that was there before surgery remains. And, it is now swollen.

	The swelling will eventually resolve (over several weeks to months), but the loose skin will remain. More surgery may be necessary, and it could be a small local anesthesia excision to tidy things up, OR a buttock lift (completion belt lift). You may have actually been an appropriate candidate for a full lower body lift rather than an extended tummy tuck in the first place, but few plastic surgeons have extensive experience with this procedure. So a tummy tuck or extended tummy tuck is offered, and in cases where more might have indded been better, the result you have shown is seen. So more (later) is needed!

	For now, I agree with my colleagues who recommend waiting to see how things turn out when the swelling is mostly gone (3-6 months). Your plastic surgeon can guide you about the next steps, if needed, and just what is involved in getting you the best result possible. Best wishes!

Jeffrey M. Hartog, DMD, MD · Answer

Thank you for providing these pictures.  It would appear that you may benefit from some additional liposuction or possible extending the incision.  It is still too soon to say 100% though.  You should defer to your surgeon on his/her recommendation.  I would advise waiting at least six months before having any additional surgery.

Barry L. Eppley, MD, DMD · Answer

The management of the love handle area is something that needs to be looked at and planned for as part of a tummy tuck procedure. Most patients will either need liposuction of them or have the tummy tuck scar extended if they are made up of a lot of loose skin with fat.  What you are looking at is not signifincat swelling in the love handle area, but the original love handles themselves. Therfe may be some hip swelling given that you are only three weeks from surgery, but the vast majoroty of what you see is extra skin and fat. They often will look bigger after a tummy tuck if unaddressed because the tummy area is so much flatter. This is an issue for a secondary surgery after you have healed from your tummy tuck to address.

18 Days Post Full Tummy Tuck and Have Huge Love Handles, Is this Part of the Swelling? (photo)

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18 Days Post Full Tummy Tuck and Have Huge Love Handles, Is this Part of the Swelling? (photo)

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