I have a horrible "shelf" or step off just above my incision from my TT. How can this be fixed? (Photo)

Question

I am 6 months post op Umbilical Float Tummy Tuck, no lipo. I have a horrible ledge, shelf, step off right above my scar. I was told it was possibly swelling but I have a feeling its fat or uneven thickness. How is this fixed? Is there anyway to know for sure if it is fluid vs. residual fat? I was instructed by my plastic surgeon to NOT wear compression. I will say, my stomach has never been flat post op, the shelf is very prominent and looks like I am pregnant.

Gerald Minniti, MD, FACS · Answer

Your surgeon should have a high resolution ultrasound (HRUS) at his/her disposal by this point in time. 5 seconds of scanning will tell the surgeon if there is a seroma or not, or if there is an issue with the abdominal wall repair (unlikely). In that case, it would be a combination of swelling and excess fat. I prefer patients wait at least 9 to 12 months from tummy tuck surgery before any additional liposuction is performed. Keep in mind that the results of liposuction would be improved with more skin advancement, but only below the belly button. This gives the surgeon the opportunity to lower you incision further and tighten skin.

Daniel Careaga, MD · Answer

while retained fluid can definitely cause a bulge in the lower abdomen after her tummy tuck based on your pictures, I would not suspect that. The important thing would be to determine whether the bulge is from an excessive fat accumulation, or if it is a residual muscle weakness (diastasis). I would determine this by examining. If it is out of stimulation, then liposuction would take care of it. If it’s a residual diastasis, you may need a revision tummy tuck to reconstruct the muscle muscles of the lower abdomen.

Joel Patrick Maier, MD · Answer

Liposuction will help flatten your tummy now that your skin and muscle have been nicely tightened with the tuck. This can be done with local anesthesia and minimal downtime and risk.

Daniel Barrett, MD · Answer

Dear susangro2570,
I understand your concern. Based on your photos, it looks like liposuction can improve the shelf. 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 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

Camille Cash, MD · Answer

The correction of this contour will depend on the cause.  If it is a seroma then it must be addressed by your surgeon.  An ultrasound (often performed in the office) can determine if one is present.  If the contour is from excess fatty tissue then liposuction should give you a flatter tummy.  Compression would be beneficial if lipo is performed.  At six months post op swelling from your surgery has resolved.

I have a horrible "shelf" or step off just above my incision from my TT. How can this be fixed? (Photo)

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I have a horrible "shelf" or step off just above my incision from my TT. How can this be fixed? (Photo)

Answers (8)

Answer: Tummy tuck results

Answer: Tummy tuck results

Answer: How can this be fixed?

Answer: How can this be fixed?

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Recommended reading

Everything you need to know about Tummy Tuck Revision

Our mission is to create a world where every investment in modern beauty is Worth It.