Bulging upper stomach 6 months after liposuction - advice? (photos)

Question

While I love the results from my abdominoplasty my upper stomach bulge and my stomach not being flat. I know it’s only been six months but looking at other pics I’m not sure if I should have something else done for a flatter tummy

Carmina Cardenas, MD · Answer

After achieving a good result because of your tummy tuck, the fat of the flap is not removed until you may safely get liposuction 6 months or beyond. 
So liposuction will help with that excess. 
Be encouraged!
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear llward0872,
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

Darryl J. Blinski, MD · Answer

Thanks for 1 posted photo but need side views! First step obtain a sub cutaneous scan or ultrasound to see if excess fa or split muscles or both. Then discuss with your previous chosen operative surgeon. Then seek virtual consults with .... My guess is maybe lipo 360 could help. Fee $6,000.

Mats Hagstrom, MD (license on probation) · Answer

Your post mentions both liposuction and tummy tuck
I’m going to address bulging after a tummy tuck because it’s much more common than after liposuction.
Before I start I’m going to tell you that anytime a patient who had an operation once to get an assessment on the outcome of the procedure they need to always include proper before and after pictures. If you don’t have before and after pictures then ask the surgeon who did your procedure to forward the ones they took. We also need to see pictures from the sides as well as the front.
There are three potential reasons why someone’s upper abdomen will bulge after a full tummy tuck.
The first and most common reason is in patients who are moderately obese and have excess visceral or intra-abdominal fat. This can usually be seen and diagnosed before surgery and can probably be seen in your before pictures.Surgical muscle tightening is more powerful and effective on the lower abdomen than the upper abdomen. With excess visceral fat the intra-abdominal volume is increased and the volume has to go somewhere. The pressure from the excess visceral fat pushes against the muscle wall from the backside and the upper part is the weakest and will bulge. The treatment for this is simple. Patients need to simply lose weight and the abdomen goes flat.
That is most likely the primary reason why your upper abdomen is bulging.
The second reason is patients who are barrel chested or have a body shape where the sternum sits well in front of their pubic bone. With muscle tightening this causes the muscle while to become oblique starting from the sternum and running in words to the pubic bone naturally causing the upper abdomen to bulge because of the relationship between the rib cage and the pelvis. This is also predictable before surgery and can be seen on before and after pictures. Patients who are barrel chested or have excess visceral fat should be told about these conditions during consultations so that they understand what their results will look like. An experienced plastic surgeon should anticipate both of these and communicate them with their patient.
The last variable is insufficient muscle tightening during a full tummy tuck. This is usually not the case. Most plastic surgeons if anything over tighten the muscles when doing tummy tucks especially the lower abdomen.
 Inpatients or barrel chested the surgeons should consider backing off on muscle tightening and being less aggressive on the lower abdomen to allow it to come out a bit otherwise it looks like the upper abdomen is doing all the bulging.
Obviously it can be a combination of any of those.
If you’d like you can try reposting with proper before and after pictures otherwise try weight loss and I think you’ll find that the results improved dramatically.
Best,
Mats Hagstrom MD

Bulging upper stomach 6 months after liposuction - advice? (photos)

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