Am I supposed to look like this at 1 year post tummy tuck? I feel like my middle was pulled tight but not my sides (Photos)

I'm 35yo, 49kgs, 4 children. I had a full TT with MR. My concern is the loose skin I still have on my sides giving me a muffin top. In my initial consult my PS said I didn't need lipo. I still have swelling/hardness around my b/button, along the scar & my pubic area. Also my b/button seems to be almost closing in on itself. I thought I would be tight on my sides & have a normal b/button. Can any of this be fixed & how do I politely tell my PS that I'm not 100% happy?

Doctor Answers 3

Tummy Tuck - 1 Year Post Op

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Thank you for your question and photos. It is difficult to determine based on the photos whether the prominence at each hip is due to the underlying hipbone or fat. It could be quite true that liposuction would be ineffective there. If your belly button has closed in with scar tissue it will likely need to be revised. I recommend that you tell your plastic Surgeon honestly what you are happy about and what you have concerns with. If further tissue removal or revision will help improve these areas they should be able to tell you and those things related to your anatomy such as hip bone prominence, may not be changeable.

All the best

Swelling and/or Tightness Post-Op Tummy Tuck

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Swelling can persist for several months and will gradually improve and will look better at three months, six months, and even one year. Frequently the pubic area and the scrotal and penis area for men can become very swollen and discolored during the first two weeks due to gravity as this is the lowest area for swelling to accumulate.

It may take several months for a tummy tuck patient’s scars to soften, for sensation to return, and for relaxing of the tight sensation in the abdomen. In the case of extensive surgery, abdominoplasty recovery can be uncomfortable and may take longer. Scars may stay red, become thick or widen. It can take 12-18 months for the scars to settle.

These can be improved with topical treatments such as BioCorneum, Scar Guard, Scar Fade and Mederma. Redness can be improved with laser treatments and the scars can be kept narrow with products such as Embrace.  On occasion, keloids or hypertrophic scars can develop and will need treatment including Kenalog, 5FU and laser.

The best thing to do if you are uncomfortable with your results to this point would be to have another follow-up appointment with your surgeon to have your abdomen examined to check the status of your healing process. Sometimes there can be loose skin or flanks that may need a revision, but if you are still healing you will want to allow a little more time before you make the assumption to have a revision procedure done. Good luck.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Unhappy with tummy tuck after a year

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Thank you for your question about your tummy tuck.

  • There are several possible explanations - all of which require an exam.
  • On your before photo,, you have a similar outward bulge. If this is bone, it can't be corrected.
  • However it may also be that the skin was sutured by bringing excess skin forward - as shown by the puckering in the 3/4 photo.
  • Other possible issues - you do have fat on the sides, or you have excess skin going around to the back or the straight incision which does not follow the anatomic contour of the body couldn't make you tight enough or, finally your skin was tightened but not the underlying fascia which is the 'envelope' for the torso.
  • Whatever the reason(s), the causes need to be identified and you will probably need a revision.
  • If your belly button is closing up, that also needs to be revised - it is common if a circular incision is used.
  • To tell your plastic surgeon, simply return - it helps to go with a friend or other ally - explain that you do see the improvement but these areas take away from your result.
  • The swellling and hardness may be the result of pullling the skin very tight at surgery 
  • Or your scars may mature slowly - it takes some people a year and half to have all the tissues soften.

Always consult a Board Certified Plastic Surgeon. Best wishes, Elizabeth Morgan MD PHD

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.