7 Weeks After Full TT, and I Have a GUT? (photo)

I underwent a full TT as well as liposuction of the posterior hips (aka saddle bags) on 8/15/12. I am 28 years old, 5'4" 128lbs prior to surgery. I lost a significant amount of weight about three years prior to the TT and I have two young children (ages 4 and 2). Photos are at 7 weeks post op and I feel like I have a gut but most of my swelling is gone! My muscle wall does not feel tight either, but I went to a highly esteemed PS who says he made them as tight as possible. What gives?

Doctor Answers 4

Bulge after TT

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I think it might be a little early to jump to conclusion. I have seen many patients who start to show good result after two monthes have gane by and the start using all of their abdominal muscles as if due to the surgery and the healing the brain was not fiing all the muscles for fear of pain. At this stage you should be healed enough to hit the gym and get those muscles to fire up  a little more and see.

Chicago Plastic Surgeon

Still have a "GUT" after tummy tuck!

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Thanks for including photos; they seem to show a competently-performed procedure as far as incision placement, quality of closure, and maintenance of circulation/good healing. What they do not show, however, is the degree of pre-operative abdominal protrusion compared to the present (rather significant and disappointing) degree of residual protrusion, and whether or not this is a superb degree of improvement (probably not given your pre-op height and weight), or if this (incompletely-healed) result is related to no plication, poor plication, residual tissue laxity simply not being capable of flattening, or even seroma. If the latter, this needs draining, now. If not, then your present situation is something only you and your surgeon can really figure out.

Having your pre-op photos would be a great help, but otherwise, once 6-12 months has gone by and everything has settled, softened, and scar tissue matured, then personal examination and consideration of revisional surgery could be entertained.

Assuming what your surgeon told you is indeed true, then there is certainly the possibility that this is as "good as it gets." But realize that at 7 weeks, you truly are not all healed with lymphatic regrowth, scar maturation complete, and swelling resolved. I see no reason to mistrust your surgeon at this time, so be patient and try not to be too discouraged--your surgeon wants you to have a great result (almost) as much as you do! Best wishes! Dr. Tholen

Skin laxity following a tummy tuck

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From your pictures, it looks like you may still have a significant amount of swelling, perhaps even a seroma (or fluid collection) that may need to be drained.  The other factor that may be affecting your result is your history of losing a significant amount of weight---I have found that any of my patients who have experienced significant weight loss have skin that relaxes a bit more following a tummy tuck than patients who have had more or less "normal" weight range.  I would revisit your plastic surgeon to make sure you do not have a seroma collection that should be drained. 

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If it was flatter earlier in the recovery it may be a seroma

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Thank you for the question and photo.  If the bulge has been there since the very beginning of your recovery it may be insufficient muscle tightening.  If the bulge has appeared over time after your recovery you may have developed a seroma or pseudo bursa.  Unfortunately both a pseudo bursa and insufficient muscle tightening will require a full tummy tuck revision.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

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