Tummy tuck 9 years ago, never truly happy with the results. Would lipo help?

Thank you for your inquiry! Without seeing the area of concern, it is difficult to tell. Liposuction may be all that is needed, but if it is 'significant buldge', you may need a revision. We would love to help you reach your goals. Schedule a consult with a Board-Certified Plastic Surgeon.

Hello, my name is Dr Igor Burko and I am a plastic surgeon at SY Aesthetics in NYC.
During a tummy tuck, the abdominal muscles are repaired and tightened. With time, the muscles can weaken and separate again. This can create the appearance of a bulge.
In addition, some patients have intra-abdominal (visceral fat) that cannot be fixed with cosmetic surgery.
Lipo will not help the bulge if the cause is weakening/separation of your muscles.
The only way to fix that is to perform the muscle repair.
I recommend you consult with a trained plastic surgeon to discuss your goals and expectations.

Thank you for your question regarding dissatisfaction with your tummy tuck results from nine years ago and whether liposuction could help with the significant bulge at the top of your abs.

Without pictures or a physical examination, it's challenging to provide a definitive answer about the best course of action for your specific case. However, I can discuss some possibilities that might be causing this bulge:

Subcutaneous Fat: If the bulge is primarily made up of subcutaneous fat (the layer of fat just below the skin), then liposuction could indeed be an effective solution. Liposuction targets this type of fat, removing it to create a smoother, flatter abdominal profile.

Visceral Fat: This type of fat lies deeper within the abdomen around your internal organs and cannot be addressed with liposuction. If visceral fat is contributing to the bulge, lifestyle changes involving diet and exercise are typically recommended.

Muscle Laxity or Diastasis Recti: Sometimes, the underlying abdominal muscles may have separated or weakened, a condition known as diastasis recti, which can cause a bulge. This would not be corrected by liposuction and might require a surgical approach, such as a revision tummy tuck, to tighten the muscles.

Scar Tissue or Post-Surgical Changes: There could also be scar tissue or other changes from the initial surgery contributing to the appearance of a bulge.

Given these possibilities, the first step is to consult with a board-certified plastic surgeon who can perform a thorough physical examination. This assessment will help identify the nature of the bulge and whether it consists of subcutaneous fat amenable to liposuction or if another issue is at play.

If the examination confirms that the bulge is indeed subcutaneous fat, liposuction could be a viable option to improve the contour of your abdomen. However, if other factors like muscle laxity are involved, a different or additional surgical procedure may be necessary to achieve optimal results.

Please seek a consultation with a plastic surgeon experienced in revision body contouring to explore your options and develop a plan tailored to your needs.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

If the bulge at the top is in the midline then it may be because they did not reinforce the upper part of the abdomen with sutures. Tightening the lower part will often cause the upper part to bulge. Unfortunately, you have not provided photographs. You may require a repeat tummy tuck or revision of this upper area. Liposuction may not help.

Best Wishes,

Gary Horndeski, M.D.

It’s hard to tell you if liposuction would be effective. Sometimes, the bulge is due to fat between the skin and muscle. This is easily pinched between the fingers and can be treated with liposuction.

Sometimes the bulge is due to increased fat inside the abdomen under the muscle. Liposuction can’t do anything about this kind of fat. If the bulge is because of increased fat inside the abdomen then only weight loss will help.

It's difficult to give a specific recommendation without photos or an in person evaluation. The bulge at the top of the abdomen will be improved with liposuction if it is from subcutaneous fat. If it is from visceral fat then weight loss will improve it. Visceral fat is located behind your muscle wall and surrounds your organs. It cannot be reduced with liposuction or a tummy tuck. If the bulge is from abdominal wall laxity then correction via a revised tummy tuck will improve it.

Liposuction may help but one need to see what you looked like before the abdominoplasty, after the surgery and what you look like now as well as your current weight. 9 years ago surgeons were not doing a lot of liposuction, especially the abdomen at the time of abdominoplasty and even today, many surgeons will not do liposuction of the abdomen or will do not as much as needs to be be done. Used to be having liposuction first followed by abdominoplasty 3 months later or vice-versa. I very seldom do an abdominoplasty without liposuction now and the results are much much better without increasing the possible complications.

You did not post photos, so I cannot be specific. If you have an area with excess fat, it probably can be treated with liposuction. Go for a consultation.

Hi herniamomma Dr Roy, one of the most amazing surgeons I have ever met, I would like you to reach me again. If I have to answer your question, I have no doubt that it will make you happy. I would like to give you some information about this process.First of all, what is liposuction?
Liposuction (also known as liposculpture) is actually a surgical procedure that breaks down and removes the subcutaneous fat layer in the parts of the body that make you unhappy and stubbornly resistant to diet and exercise.This is not a weight loss procedure; instead, it is another way to remove an unresponsive fatty deposit in otherwise healthy individuals. It is a method we apply to our patients who cannot get a solution after the diet list prepared by the dietitian with the guidance of the internal medicine specialist and family physician.
2. In which areas is liposuction performed?
To list some of the common "problem" areas of the body where Liposuction is performed on our eligible patients after careful and meticulous anamnesis.
Double Chin, Back of NeckUnder the Upper Arms For Women, Outer Thighs or Saddle Bags, Bra Strap Area, Abdomen or Belly to reduce the size of the Breasts, For our male patients, the number of men who are exposed to gynecomastia on their breasts (as a result of sports drinks) is considerable.Less common areas include the ankles, inner thighs and upper back. The optimal area for each individual is unique because each person responds to diet and exercise differently. The success of dietitians here is considerable. Of course, qualified plastic surgeons focus on the points where patients are unhappy to determine the body areas where liposuction makes sense.
3. So how do you know if you are an ideal candidate for this surgical procedure?
The best candidates for liposuction are healthy individuals who are close to their target weight and still cannot find a solution after seeing an internist and family physician and a dietitian. Of course, the most important issue that should not be forgotten is our patients who do not smoke.
Ideal patients have persistent subcutaneous fat, where the fat is located between the muscle and skin, and not visceral fat, where the fat layer is located under the muscle layer around the abdominal organs.
Additionally, it is very important for surgeons to evaluate the condition of a potential patient's skin before recommending liposuction. Patients with good skin elasticity are good candidates for liposuction, whereas patients with loose skin or cellulite are not suitable patients for ligposuction, as these conditions can result in uneven skin.
4. So, is Liposuction a weight loss method? How much fat can be removed?Of course, contrary to popular belief, liposuction is not a weight loss treatment. Instead, it is a fat reduction procedure. The amount of fat that can be removed from an area during a single procedure varies depending on a variety of factors, including the surgeon's assessment of the patient's health and aesthetic goals.
5. Another important question is: How does a patient prepare for liposuction surgery?
Plastic Surgeons will set a date once you decide on liposuction and provide instructions that you must follow by that date, but in general, it is very important to enlist a friend or family member who can accompany you to help with transportation to and from the surgical center and assist with post-operative care.Ekinci, you should tell the physician who took your anamnesis beforehand about all the medications you use, your complaints, and most importantly, the medications you use. For example, some medications such as Aspirin and blood thinners should be paused before the procedure. In some cases, blood work is done beforehand to ensure the client is a good candidate for anesthesia. Finally, the day of surgery will be a period during which no food or drink should be taken; this is usually approximately 12 hours before your appointment time.
6. What happens during the procedure? How to do it?
Liposuction is a surgical procedure that involves making small incisions in the skin and inserting an instrument called a cannula into the fat pocket. This cannula is attached to a suction device or a syringe to remove fat.
This is typically an outpatient surgery, so while patients may be placed under general anesthesia, they are usually allowed to go home the same day as surgery.
7. How is the recovery?
For most procedures, the patient can return to work within a few days and resume all normal activities, such as exercise, in 2-4 weeks or less, although recovery and postoperative care vary depending on the area treated and the amount of fat removed.
Following the instructions is the best way to have a recovery that is short and as painless as possible. Some discomfort may be felt. However, lifestyle choices such as rest, hydration, and not smoking will make recovery time faster and complications fewer. The most common post-surgical effects may include some swelling, bruising, and tenderness in the procedure area. The surgical team will give you some options for post-operative pain relief, as well as painkillers to avoid.

You failed to post any photos so you must do an in person or virtual consult with. Until that’s done or you post photos the discussion cannot proceed. Expect revision fee to range from $5000-$15,000. Again, virtual consult.