Firm bulge above incision 8 months after tummy tuck - what could this be? (photos)

I might be a seroma (fluid collection), but I doubt it. As you mentioned, paradoxical hypertrophy happens after Coolsculpting, so not this. It is likely some residual thickness which can be re-treated with careful liposuction to maximize your result and meet your expectations. Thank you and I hope this helps.

Most likely it is a thick scar, possibly result of fat necrosis after TT/liposuction. An ultrasound evaluation may help to better define problem and decision about further treatment. Good luck.

Dear HJL20,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your question and photographs. Unfortunately without an in-person examination it is impossible to offer good advice. Possibilities include muscle laxity that was present even before surgery and not addressed but revealed once the excess skin was removed, a fluid collection like a seroma/hematoma, fat necrosis, etc. I would seek out second opinions.

I encourage you to return to your surgeon to explore this area further. It could be related to a seroma which could be diagnosed with an ultrasound. Since you didn't have muscle repair it could be the result of muscle wall laxity. Your surgeon should be able to help with further evaluation.

I would suggest getting an ultrasound to see if you have an organized seroma. If you do, it will need to be excised.

Photos demonstrate a frequent post mini TT bulge. Ultrasound examine needed to see if seroma, scar, fat or all three issues. Might offer ultrasound guided liposuction reduction of the area. Fee $5,000. Best to virtual consult with....

There are multiple explanations why you could have fullness in this area.
Does seven continues fat layer naturally becomes thin at the lower abdomen transitions to the mons pubis. This varies somewhat between individuals but most people have a subcutaneous fat layer that becomes thin right between the lower abdomen and the pubic area. The subcutaneous fat is usually thickest around the belly button.
When that stripper skin is removed during a mini tummy tuck the two skin edges better approximated with stitches often have a mismatch with a fat from the mid abdomen Bing thicker than it is just above the pubic area. When that stripper skin is removed during a mini tummy tuck the two skin edges better approximated with stitches often have a mismatch with a fat from the mid abdomen being thicker than it is just above the pubic area. Well this is the case and plastic surgeons should remove fat from the upper skin edge so there isn’t a step off at the incision(scar).
If you have previous pregnancies then you most likely having muscle separation and abdominal bulging causes the same appearance as well.
There are generally four variables that determine what someone’s abdomen looks like.
If someone doesn’t like the way they rub them and looks it is almost always because of one or more of those four variables. This is generally true whether someone has had cosmetic surgery or not.
Before variables are abdominal skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies or excess visceral or intra-abdominal fat,
The contour irregularity is related to one of those four. It shouldn’t be rocket science to figure out if the subcutaneous fat layer it’s thicker just above your scar than below the scar. it also shouldn’t be that difficult to determine if your muscle wall bulges.
If it’s a mismatch with thicker subcutaneous fat above the scar because of failure to defend the upper skin edge appropriately then this could be easily improved with a small amount of liposuction.
To make a quality assessment on the outcome of the surgical procedure we generally always want to see proper before and after pictures. If you don’t have before and after pictures and ask your surgeon to forward the ones they took and always show before and after pictures if you want input on the outcome of your procedure.
My best guess is this represents a slight difference in subcutaneous fat thickness combined with mild muscle separation.
I suggest having a few in person Second opinion consultations.
Best,
Mats Hagstrom MD