Could the Doctor Have Done Better? Or is It my Bad Skin?

Wanted to post again to say that I did go to a Board certified Dr.(a top Dr. in the area)I'm wondering what he did wrong? He said my fat is pooching out because my stretched skin isn't holding it in. He said he couldn't remove more of my stretch marked skin Because then their wouldn't be enough to close me up. So then did he not remove enough fat? Is this the fault of the Dr. or just my bad skin? I paid so much $$ even if I lost weight I'd still have hanging skin! Do I go to HIM for my revision?

Doctor Answers 12

Tummy Tuck Revision

The healing process from a tummy tuck takes at least 2-3 months. It is normal to have some bulging, particularly in the lower abdomen. You may find that as time goes by the bulging will improve. Having said that, it does appear that the bulge that you have is due to some excess fat in the skin above the scar line. This is not that uncommon though the degree of excess in your case is significant. Here's why that happens.

The amount of fat in the middle of the abdomen is usually a lot more than the amount in the lower abdomen and groin. During a tummy tuck the skin and fat are moved down into a lower position and the excess skin and fat are removed (together). In some cases liposuction is also performed to reduce the excess fat in the abdomen where the skin is not being removed. If this is not done there will be a thicker amount of fat in the skin above the scar line than below since the skin below the scar line started out with much less fat to begin with and the thicker middle abdominal skin is now being sewn to it. This can also be corrected by trimming (thinning) the amount of fat above the scar line before closing the incision.

My guess is that you did not have liposuction at the time of your tummy tuck and the difference in the thickness of the skin was not obvious at the time of surgery. The good news is that this can be revised and look much better in the end. You are now about two months since your surgery. I would recommend that you wait at least one more month (even longer would be better) before considering a revision. Once the healing is fully complete and the tissue is soft you can consider having this revised. The revision would require removing the old scar and reducing the amount of fat above the scar, then closing the incision again. If you wait a while your results will improve on their own, but if its not everything you wanted you can have a revision and definitely make an improvement.

I hope this info helps!

Miami Plastic Surgeon
4.9 out of 5 stars 20 reviews

You may need to have revision

 Your surgeon should  revise it for you and you should  pay for the surgery center and anesthesia. When you go to see your surgeon,please do not accuse him of not doing a good job,but ask him if he can do better. If he is happy with the result,then find another surgeon to give your better result. The problem is that you did not have liposuction above the incision area and the there is mismatch between the above the incision fat thickness and  below the incision. The other issue is the location of the incision that is too high and not even.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

Tummy tuck problems

Hello again.  I am glad you chose to go to a good doctor and I'll bet they aren't proud of the result you have so far. It is true that in most cases you cannot remove all of the stretch marked skin and that limits the results to some degree.  But you should still look flat.  The indented scar is causing the skin to roll over it and look like there is more extra still tha there actually may be. 

Two possibilities for why the scar looks indented is either how your body is scarring or possibly if the doctor tried to stitch the incision down to the muscle to stop it from drifting up higher than where it is now.  These can both cause what you have.  Again, with a good doctor, I'd advise you to massage the area regularly and wait 6 months and see if it doesn't get better on its own.  Otherwise a revision of the entire scar could smooth and flatten the area but won't move the scar down any.

Good luck!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Tummy tuck result

It seems that your result may still have some removal that can be done.  Sometimes we do that because patients have other medical issues and we don't want to push the envelope to the point where there's going to be a wound healing problem because there was so much tension.  If that's not the case, you should definitely go back to your board certified plastic surgeon and surely he will help you reach the point you are looking for.  As far as being a top doc, that's often paid advertising so it's tough to go by something like that.  More importantly will be the way he resonds to helping you out with your problem.  Best wishes,

Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 120 reviews

Tummy Tuck Scar

You don't say exactly how far post op the photos are, but you will need to wait at least 3-4 months for the swelling to improve before rushing to judgment. That being said, I believe that your scar is a tad high and if things don't improve with further healing, I would consider a revision.

Mark Preston, MD
Columbus Plastic Surgeon
4.4 out of 5 stars 21 reviews

You need a revision tummy tuck

A tummy tuck is a safe and effective procedure to contour the abdomen, re-create a tight waist, and remove additional skin, fat, and stretch marks. After such a procedure, every patient must realize that there is a recovery process that always occurs. In your case it seems that you have extra fat and a little extra skin that is causing this bulge.

To create the result that you want, your best bet is to approach your plastic surgeon and let him or her know about your concerns and ask how both of you can work together to address them. Like all surgery, it is impossible to determine exactly how the results will come out. By working together, both of you can construct a treatment plan that will address these concerns and give your beautiful long-lasting result.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 108 reviews

Tummy tuck revision

I agree with my colleagues that it is always difficult to tell fully from photos but it appears to me that you have a very "high" abdominoplasty incision that is  very close to the belly button.  It also appears that there is residual loose skin and fullness.  I would always recommend waiting until at least 3 months and usually 6 months before considering a revision but it is certainly a conversation that you should have with your surgeon.  Sometimes skin can stretch out again and even though everything at the time of the surgeon seems adequately tight, at 3 months it appears somewhat loose again.  I tell patients like a "haircut" analogy, I can alway go back at a later time point and tighten it further and possible remove any further loose skin if necessary.  I hope this helps!


James F. Boynton, M.D., F.A.C.S.

James F. Boynton, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 42 reviews

Unhappy tummy tuck

It is always better to compare the pre and post-op photos. Be that as it may, if you are unhappy you should review things with your doctor, but you probably have to wait 6 months or more to revise it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Dissatisfied with tummy tuck (PHOTOS)

The timing of the picture is important as it may reflect how firm or adherent your scars are. If these are within the first 3 months after surgery, I would allow time for the results to settle and consdier revsiions between 4-6 months. Stay in close contact with your existing plastic surgeon who will most likely work to get you a better outcome.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Postoperative result

You will likely need a revision, however, it is imperative that you allow sufficient time for the swelling to improve and the scar tissue and skin to remodel.  I have been surprised at how well the skin will contract with time, leaving less revision work to be done.  A compressive garment will help with the swelling that often occurs in the lower abdomen.  Make sure that whatever compressive garment you are wearing COVERS the bulging area.  Garments will often "creep up" the abdomen leaving a buldge in the lower abdomen which may contribute to swelling in that area.

LaDawn Talbott, MD
Reno Plastic Surgeon
4.4 out of 5 stars 13 reviews

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.