How Do I Determine What Went Wrong?

If I could just get some guidance as to HOW to determine what is going on or what went wrong. Four months post tt, lipo of flanks, upper abdomen.Over the months feeling larger and "pregnant like belly." I can understand if I was not a good candidate (although my PS should have determined that pre-op) now PS mentions visceral fat, haven't gained weight, PS just told me to lose moderate weight. Photos show I was flatter post op then get larger. Will a different PS be able to determine or advise?

Doctor Answers 4

Roundness after a tummy tuck

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Roundness of the belly after a tummy tuck is a rare but significant concern.  It usually happens because some people do have more fat inside the muscles than outside the muscles.  During a tummy tuck only the fat outside the muscle is removed.  That being said, when there is an increase in size of the belly many months post-op, it is concerning for the development of a hernia or a break in the repair of your rectus muscles.  I would contact your plastic surgeon for an exam.

How Do I Determine What Went Wrong?

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It might be possible to respond to your question if there were some pre-op photos with which to compare these after photos. 

One limiting factor in many patients in terms of tightness of the abdominal muscle wall is the volume of the intra-abdominal contents. In, for example, overweight patients, the surgeon cannot make as slender an abdomen compared with a patient who is at ideal weight.

If indeed your abdomen was tighter at a month than it is now, it is possible that the sutures for the muscle repair have pulled out and failed. That is something that your surgeon can determine, but an online surgeon cannot.

Thanks for your question, and for the posted photos, All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

What went Wrong

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I agree with Dr Hughes. You may want to show your "before" picture. It is possible that your muscle tightening became loose. Your surgeon should be able to determine that.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

What Went Wrong with the Tummy Tuck?

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  Maybe nothing.  If you provided a preop picture, this would be instructive.  Visceral fat in some people creates a considerable hurdle in tummy tucks, and only weight loss will remedy this.  The belly button and incision look reasonable, and your view from the front looks good.  If the plastic surgeon feels that you have been tightened sufficiently with the plication, there may not be much to do.

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