2 years post-op - What happened to my tummy tuck? Should I have a revision? (Photos)

Question

I had a TT 2 years ago and am now 73. Initially, I was thrilled but as time went by not so. I went back to the physician and he suggested having a ultra sound which proved nothing. Because of my age and spinal issues I did tell him I didn't need a rock hard stomach but wanted to be able to wear a fitted dress. I think I'm back to where I started. I eat clean and get moderate exercise. In you opinion what do you think is causing this? And should I have a revision? Thank You!

Eric Wright, MD · Answer

A few different issues may be contributing to your current presentation. An ultrasound is a reasonable place to start, not only to evaluate for a seroma (fluid collection) but to also evaluate the abdominal wall muscles. Laxity in the abdominal wall occurs due to weight fluctuations, pregnancy and as we age. Assuming the muscles/abdominal wall laxity was corrected 2 years ago, this may have stretched or become loose around the previous sutures. Retightening the abdominal wall with mesh reinforcement would be one option if this was found on imaging or physical examination. I would follow up with your plastic surgeon for a repeat examination to discuss your concerns. Best of luck.

Dr. Eric J. Wright

Dr. Eric J. Wright

Carmina Cardenas, MD · Answer

Based on your photos your muscle is the problem no the excess of skin. 
In my opinion you need only a nice and tight muscle repair to achieve a flat abdomen. 
It is not necessary to re-do the entire Tummy tuck, only the muscle repair. 
Be encouraged! 
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear Intelligent634868,
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

Connie Hiers, MD, FACS · Answer

You either have had weight gain, or you may have some food allergies causing your colon to expand.  Either way, please discuss this with your medical doctor.

Camille Cash, MD · Answer

Thank you for your photos and questions. From your photos it appears that either your muscle repair has failed, or the abdominal wall has become lax again.  Surgical correction of the abdominal wall is the way to get you back to a nice flat tummy.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, there appears to be an early postoperative frontal view, demonstrating a flat abdomen, narrow hips and waist. The 3 later postoperative oblique views appear to demonstrate a full abdomen, full hips, and full flanks, suggesting significant weight gain. 
 Age is a number. Physical health is extremely important. I would first attempt a strict dietary regimen and supervised exercise under the control of your primary care physician to lose the weight you apparently have gained over the past 2 years. You mentioned "spinal issues"...Has your level of activity decreased over the past few years?
BMI, or body mass index (weight in kg / square of height in meters) is one criterion to determine the results of a cosmetic surgery. You can find BMI calculators on the internet. If your BMI is greater than 30, the cosmetic result will not be optimal. If your BMI is greater than 35, your operative risk will rise. 
If your BMI is under 30, you may wish to consider liposuction if all non-surgical options fail. However, the state of your physical health is paramount. Preoperative medical clearance is definitely required.
Best wishes...

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