1 year post op from TT and stomach isn’t flat. Advice? (photos)

It is difficult to assess your results without before and after photos, but it does appear with the limited view that you have some deep, visceral, omental fat that remains after tummy tuck.  That fat requires weight loss, no surgery available for that.  Data shows that the complication rate for tummy tuck is decreased for patients with a BMI under 30 compared to those with a BMI over 30.  The aesthetic outcome is also better with lower BMI.  

It looks like you still have fat, and may have looseness in your abdominal wall. You need to discuss with you plastic surgeon, and specifically if he/she tightened your abdominal wall. Good luck!

Unfortunately, there is still fat in your abdomen, which is giving you this shape.  The fat can be either internal (visceral) fat or subcutaneous fat.  The first type is only amenable to weight loss - we don't have a surgical method to fix it.  The subcutaneous fat can be treated with liposuction.Best to return to your plastic surgeon to see how much of your shape is related to internal fat.  But be prepared that you may have to do much of this work yourself, with diet & exercise, FDA approved weight loss medication or bariatric surgery.

Thank you for the question and photos. It is difficult to answer your question without examining you however from reviewing your photos it appears that you may have visceral fat. It is best to have an examination with a board certified plastic surgeon. You may benefit from weight loss first prior to another surgery. Good luck.

Thank you for sharing your question and photograph. Unfortunately without an in-person examination of your tissues it is difficult to offer definite advice as to how to best improve your results.  Possibilities include weight loss, need for additional muscle tightening, liposuction, etc.  I would speak to your surgeon at length as to why differences between your expected and actual results developed.  Hope this helps.

Dear Midway13,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after 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

thanks for the picture. It tells the story. 
You have internal (visceral) fat that is not a plastic surgical problem. I’m sorry your surgeon failed to inform you of this beforehand. 
Weight loss by bariatric Surgery is your best bet for long term results, in my opinion. 

If you have deep fat in the abdomen, a tummy tuck will not produce a flat stomach. For this reason, among others, I turn away women who are obese, understanding that the procedure will not achieve their goals. In your case, there is also the question of whether your musculature is weak as well.  A review of your operative record could be helpful. Additionally, have you returned to your surgeon to voice concerns? Best wishes.

I am sorry to hear about your concerns after tummy tuck surgery.  Physical examination would be necessary to determine what the cause of the abdominal wall prominence is.   "Differential diagnosis" include abdominal wall muscle laxity,  subcutaneous adipose tissue,  and/or intra peritoneal (AKA "visceral") adipose tissue.

 Depending on the diagnosis, treatment options will vary: 

 Treatment of abdominal wall laxity: muscle plication.
 Treatment of subcutaneous adipose tissue: liposuction surgery.
 Treatment of intraperitoneal adipose tissue:  diet and exercise.

 I hope this helps.