How Common is It for Muscles That Have Been Fixed During a Full Tummy Tuck to Reappear and Pooch Back out Again?

I ask this because I have read more than one comment on this site from women who have had full tummy tucks only to have their stomachs pooch back out several months after recovery. Some have provided pictures that show a great healing process but then their stomach starts to bulge again. I am not talking about weight gain. I am considering getting a full tummy tuck for severe diastasis but would be so disappointed to have the pooch return. Is this common?

Doctor Answers 6

Recurrent Abdominal Fullness After A Tummy Tuck

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Dear Newmomat37, The most common reason for regaining fullness in the abdomen after having a tummy tuck is recurrent weight gain but you are looking for other sources for this problem.  One possible cause could be the failure to recognize a significant diastasis(seperation) of the rectus muscles which are then not repaired.  This continued area of fullness can restretch the soft tissues of the abdomen including the skin.  Fluid collections between the muscle and the skin called seromas can also be responsible to fullness returning to this area.  Failure to repair a hernia in this area can also be responsible for the pooch's return shortly after surgery.  Another source of recurrence is performing an abdominoplasty in a patient where the majority of the fat is stored inside the abdominal cavity and not on the outside.  Because this fat is not going to be addressed by plicating the rectus muscles nor by removing the extra skin, over time the abdomen will again stretch leading to a less than satisfactory result.  Finally, as I always tell my tummy tuck patients; my job is to put the muscles back into place, their job is maintain them.  A tummy tuck is not a reason to stop exercising and maintaining a healthy lifestyle.  Your final question was, how common is this problem of reoccurence of abdominal fullness after a tummy tuck and the answer is rarely if all of the above issues have been accounted for.  Hope this helps and good luck.

Saint Louis Plastic Surgeon
4.7 out of 5 stars 88 reviews

Abdominal bulge after tummy tuck

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It is very unusual for the abdominal wall to bulge again after a properly performed tummy tuck. The muscle plication (tightening) is done with permanent sutures which rarely ever become loosened. Although this could occur with weight gain or excessive exercise right after surgery. Consult with a board certified plastic surgeon to see if you are a good tummy tuck candidate.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 410 reviews

Pooching of the abdomen after surgery not too common

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It is not very common for either stretching of the muscles or breakage of the repair of a diastasis long term after a tummy tuck. In the immediate postoperative period possibly up to 8 weeks you will be at an increased risk to rupture the repair of the muscles. Typically, this can be the result of severe nausea and emesis right after surgery; spasms of coughing or sneezing early on or lifting very heavy weights. If you do put on weight of have significant fluctuations of weight long term, this may also happen but again, it is not very common.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

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Recurrence of Abdominal Bulging after tummy tuck

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This is a rare problem after abdominoplasty, but I have seen it occur.  If the abdominoplasty is done in a thin patient with significant diastasis, there are 3 reasons that this can happen.  The plication may not have been tight enough to correct the diastasis.  Secondly, the suture(s) used to repair the diastasis can break or pull through the weakened muscle fascia especially if the fascia is thinned out.  I have had a patient rupture her repair by doing too much lifting too soon after the procedure.  Lastly, I have seen this occur over a longer time period postoperatively which I think is due to the abdominal tissue weakening over time.

Again, this is not a common problem and should not impact your decision. 

Pooching after Tummy Tuck

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Great Question!

Tummy Tucks are the Cadillac of Body Shaping . A 16-->6 or a 18__.10 is not uncommon. However, it is up to you to maintain the shape of your body. THe more overweight you are before the tummy tuck, the more you have a chance to "reaquire" the pooch as it is stretched out by the contents of your abdomen

Get  busy dieting and exercising to keep the pooch away

Dr jeneby

Separation of abdominal wall muscle plication

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Thank you for the question.

Some of the best  results seen after tummy tuck surgery are seen with patients who have “severe diastasis";  the plication  of the abdominal wall muscles that have spread with pregnancy and/or weight gain/loss serves to firm up the abdomen as well as narrow the waistline.

The incidence of recurrence of the diastasis (or  “pooch”) should be very low in the hands of well experienced board-certified plastic surgeons. Although there are no studies that I am aware of  I am sure the incidence would be significantly less than 5% of all patients who undergo tummy tuck surgery by the appropriately trained/experienced surgeons.

I hope this helps. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.