7 months after tummy tuck. Is this normal bulging/asymmetry?

Question

I had a tummy tuck about 7 months ago after weight loss from a Gastric Bypass 10 years ago. I've noticed a bit of asymmetry above my newly created belly button, the left bulging out more than the right. I notice when I do a sit up, intentionally or from a laying in bed situation its still painful there, and the bulge itself hurts. Is this normal? I've had a CT scan due to an ovarian cyst- so I'd think that rules out hernia?

Alan Gonzalez, MD, FACS · Answer

Hello @hchecca, thank you for your question. It is important to take into account several aspects among which is the surgical technique applied, and to evaluate if there is something else at a systemic level. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs.  Best wishes! Alan Gonzalez MD, FACS.  American Society of Plastic Surgery Member (ASPS),  International Federation for Adipose Therapeutics and Science Member (IFATS),Colombian Society of Plastic Surgery member (SCCP).

J. Timothy Katzen, MD, FACS · Answer

Dear hchecca,

Asymmetry and bulging in the abdominal area after a tummy tuck are not necessarily normal, especially when accompanied by pain. These symptoms could be the result of various factors such as swelling, seroma, hematoma, or even a muscle repair issue.

While it's possible a hernia might be ruled out by the CT scan you had, it's crucial to consult with your plastic surgeon about these symptoms. They are best equipped to evaluate your condition, as they are familiar with the specifics of your surgery and your recovery progress.

Physical examination, and potentially other diagnostic imaging or tests, may be required to determine the cause of the bulging and discomfort you're experiencing. Early identification and intervention can help address the issue effectively.

Please reach out to your surgeon as soon as possible and make sure to report all the symptoms you're experiencing.

Sincerely, Dr. Katzen

Daniel Barrett, MD · Answer

Dear hchecca,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You did not post photos, so I cannot be specific. I would suggest going back to your surgeon and asking to check for residual fat. If your surgeon finds nothing, then ask for an ultrasound of your abdomen to look for a fluid build up or another problem.

Camille Cash, MD · Answer

While mild asymmetry in and of itself is not uncommon, the addition of pain with the asymmetry warrants further evaluation.  The correct way to address this will vary based on the diagnosis.  I encourage you to return to your surgeon for an assessment.

Mats Hagstrom, MD (license on probation) · Answer

All people have inherent asymmetry. To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before and after pictures and ask your surgeon to forward the pictures they took. Your surgeon is also the correct person to talk to about concerns regarding the outcome of your procedure.
Without seeing pictures, we can’t begin to make an assessment.
It’s not uncommon for patients to notice asymmetry after cosmetic surgery. Most of the time they symmetry was there before the surgery, but people never looked at their body critically preoperatively.
The rib cage can have different amounts of forward, projection on one side, and on the other, causing the abdominal wall to drape asymmetrically.
Consider reposting it with proper before, and after pictures, follow up with your provider or schedule in person a second opinion consultations.
Best,
Mats Hagstrom MD

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