6 months post-op- I still look pregnant, where do I turn next? (photo)

Question

I had the surgery by a “top surgeon” in Beverly Hills. I am 6 months post op DR repair and tummy tuck. I am extremely disappointed because I am not flat whatsoever. My doctor said that there’s no swelling and I just have lax fascia and there’s nothing more he can do. I’ve never seen this before. Where do I turn next?

Daniel Barrett, MD · Answer

Dear catlady72,
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

Shana Kalaria, MD · Answer

Hello there. You will likely benefit from a repeat (revision) tummy tuck with repair of the diastasis rectus again. In these cases you sometimes have to repair the fascia in multiple layers to get it to be tight. This will involve the same incision that you currently have and the technique will involve opening up the entire previous tummy tuck and redoing it. Please see a board-certified plastic surgeon as your case is complex. Good luck!

Connie Hiers, MD, FACS · Answer

An examination is needed to see what the problem may be. I would suggest getting a second opinion from another surgeon.

Camille Cash, MD · Answer

I'm sorry you are unhappy with your tummy tuck results.  The usual culprit for this appearance is visceral fat which is the fat that is behind the abdominal wall and cannot be addressed by a tummy tuck.  The other potential reason could be that the muscle wall laxity was not fully addressed.  I encourage you to visit with a board certified plastic surgeon near you for an in person evaluation.

Mats Hagstrom, MD (license on probation) · Answer

Plastic surgeons in Beverly Hills have no particular skill or talent that supersedes any other geographic area. Sone of providers in this area are generally driven by financial gain.

Some simply happen to enjoy living in that area or that is where they grew up.

plastic surgeons being famous has no correlation with talent.

If anything I would say there is an inverse correlation betweenthose who are“ famous“ and those who are skilled.

The most talented plastic surgeons I know have very little online presence certainly don’t advertise and do not spend their time writing books or being interviewed on television. They are content being caring physicians taking care of their patients and spending time with their family.

Patients who bulge after a full tummy tuck typically either have excess visceral fat that should’ve been diagnosed during an in person consultation prior to the procedure or had insufficient muscle tightening.

Sometimes it can be a combination of both.

Individuals who are barrel chested can sometimes end up having bulging of the upper part of the abdomen and this can also be predicted before the procedure.

Without having been present at the procedure there’s no way to know how the procedure was performed.

A second opinion consultation should easily be able to differentiate if visceral fat is an issue or if you have recurrent diastasis recti.

Weak abdominal fascia is something sometimes  seen but when a muscle repair is done formally and thoroughly it typically holds unless there is constant pressure from access visceral fat.  If someone truly has weak fascia then there is always the option of reinforcing it with mesh.

To get an assessment you need an in person consultation. To be prepared for that bring before and after pictures and a copy of the operative report from your first surgeon.

To find the most talented plastic surgeons for a tummy tuck procedure have in person consultations at which time you should ask providers to show their entire collection of before and after pictures. Ask the provider to show examples of their best results, average results and less than outcomes.

Seeing a handful of examples representing the best results of their career is insufficient to see what average results look like and to get confirmation of how many of these procedures the surgeon has performed.

An experienced provider should have no difficulty showing 100 or more sets of before and after pictures for full tummy tucks. Highly experienced providers will have many hundreds or possibly thousands up before and after pictures for this procedure.

Look carefully at every picture and make a note of who gets the most natural looking belly buttons. This in combination with a Loosid scar that follows anatomic contours naturally.  Patients should also look critically at the sides and from a back view. A thorough plastic surgeon will take the entire torso into consideration when planning and performing this procedure.

These are the hallmark of the most talented providers.

I also recommend reading all reviews on all various physician review websites avoiding providers with any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.

Good luck,

Mats Hagstrom MD

6 months post-op- I still look pregnant, where do I turn next? (photo)

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