14 months post op and I still have a shelf. Would I benefit from a tummy tuck revision? (Photo)

Question

Female, 34, 5’4”, 128lbs Tummy tuck January 2025 including diastasis rectus repair and liposuction It’s been 14 months since the procedure and I still have a shelf. Above the incision is fuller than below. Would I benefit from a revision? My PS said he anticipates a revision to only show an 30% improvement and the shelf is largely due to my anatomy. I’m not quite sure I understand. I imagine removing a little more skin and a little more lipo would do the trick. I’d love a second opinion.

Shlomo Widder, MD · Answer

Dear Chicagoian,
   Thanks for posting your post operative picture. From observing your picture I notice muscle laxity of the upper abdomen and lower abdomen. The muscle laxity of the lower abdomen appears worse. That condition can occur for different reasons : 1.  If the surgeon did not attach the muscle to the pubic bone. 2. You became too active too early after surgery. 3. Large fibroid.
   Obviously you are bothered by your condition. If Fibroid can be ruled out than a revision can be beneficial to you by tightening the muscle from the chest bone to the pubic bone and attaching the lower muscle to the pubic bone with permanent synthetic suture. After surgery you should avoid strenuous activity for 2-3 months.
   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly check the before and after pictures in the photo gallery to make sure that the are numerous, consistent and attractive with flat stomach, nice narrow waist line and improved posture.
                            Best of luck,
                                                Dr Widder
                                   widderplasticsurgery.com

Randal Haworth, MD, FACS · Answer

At 14 months, you are far enough out that what you’re seeing is likely close to your long-term result, so it is reasonable to ask about a revision.
A “shelf” above the incision can happen from a few different things:

Natural abdominal anatomy
Residual thickness/fat above the scar
Scar tethering
How much lower abdominal skin could safely be removed the first time
So your surgeon’s comment is not necessarily wrong. In some patients, a revision can help, but it may only give a modest improvement, not a dramatic one.
Could more skin removal and more lipo fix it?
Sometimes yes, but not always. More skin and more liposuction can improve the contour if the issue is mainly excess tissue. But if the shelf is partly due to scar position, tethering, or your natural shape, then aggressive revision can still leave some fullness and may risk healing problems.
My honest take
You may benefit from a revision, but I would go into it expecting improvement, not perfection. If your own surgeon is estimating only about 30% better, that suggests the anatomy may truly be limiting.
I would recommend a consultation with a qualified, board-certified plastic surgeon for a second opinion, ideally someone who performs tummy tuck revisions regularly. They can tell you whether this is best treated with:

scar revision
limited skin excision
additional liposuction
or a combination
Good luck!

Darryl J. Blinski, MD · Answer

Based on one posted photo side view, revision is indicated. I recommend virtual consult with. Excision of scar, Lipo of areas where the J -Plasma. Fee $4,000. Again best to virtual consult

14 months post op and I still have a shelf. Would I benefit from a tummy tuck revision? (Photo)

Answers (3)

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