I had a full tummy tuck 1 year 7 months ago. I expressed concern about the fatty deposits on top of my ribs but my surgeon said the TT would resolve it. I'm very happy with my TT, but the fatty deposits stayed the same. Surgeon did liposuction on the area 10 months ago. Now the area has excess asymmetrical skin. Will this resolve? Can I fix this?
November 13, 2023
Answer: Tummy tuck results To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. If you don’t have a before, and after pictures and ask your surgeon to include the pictures they took. Without knowing what you look like before the procedure it’s hard to address the changes from the operation. In order to obtain skin tightening from a tummy tuck, the skin and the fat layer needs to be separated from the underlying muscle fascia. We sometimes refer to that tissue, separation as undermining. Different plastic surgeons will have a different opinion in regards to the extent of how much undermining should be done, especially on the upper abdomen. Skin that is still adherent to the underlying muscle fascia will be limited, in its ability to be pulled tight and become thin. Ideally undermining should be done quite higher on the upper abdomen, ideally up over the rib cage to the inframammary fold. There are potential drawbacks to extensive undermining, and this process can potentially increase complication rates, but can also substantially improve the aesthetic outcome, especially leaving the upper part of the abdomen (the area below the breast), looking consistent with the rest of the abdomen. If that wasn’t done, then patients will have a lack of improvement on the lower chest and upper abdomen. Compensating later, for a lack of insufficient undermining with attempted Liposuction is one approach, but understanding the primary problem which is that the upper abdomen did not become incorporated with the full tummy tuck procedure is most likely the underlying problem. Different plastic surgeons have different approaches to how this should be done, including the extent of undermining. There are no absolute right or wrong answers. As I mentioned earlier, there are also safety issues to take in the consideration. It looks like you also have substantial fullness on your backside that could be addressed with a more extended tummy tuck for well done Liposuction. I’m not sure redoing the tummy tuck at this point is justified. I suggest you continue following up with your provider and you may want to consider scheduling a few in person second opinion consultations with other plastic surgeons in your community. It’s important to recognize there are significant differences in outcomes, depending on both patient, candidacy, and provider selection. Best, Mats Hagstrom, MD
Helpful
November 13, 2023
Answer: Tummy tuck results To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. If you don’t have a before, and after pictures and ask your surgeon to include the pictures they took. Without knowing what you look like before the procedure it’s hard to address the changes from the operation. In order to obtain skin tightening from a tummy tuck, the skin and the fat layer needs to be separated from the underlying muscle fascia. We sometimes refer to that tissue, separation as undermining. Different plastic surgeons will have a different opinion in regards to the extent of how much undermining should be done, especially on the upper abdomen. Skin that is still adherent to the underlying muscle fascia will be limited, in its ability to be pulled tight and become thin. Ideally undermining should be done quite higher on the upper abdomen, ideally up over the rib cage to the inframammary fold. There are potential drawbacks to extensive undermining, and this process can potentially increase complication rates, but can also substantially improve the aesthetic outcome, especially leaving the upper part of the abdomen (the area below the breast), looking consistent with the rest of the abdomen. If that wasn’t done, then patients will have a lack of improvement on the lower chest and upper abdomen. Compensating later, for a lack of insufficient undermining with attempted Liposuction is one approach, but understanding the primary problem which is that the upper abdomen did not become incorporated with the full tummy tuck procedure is most likely the underlying problem. Different plastic surgeons have different approaches to how this should be done, including the extent of undermining. There are no absolute right or wrong answers. As I mentioned earlier, there are also safety issues to take in the consideration. It looks like you also have substantial fullness on your backside that could be addressed with a more extended tummy tuck for well done Liposuction. I’m not sure redoing the tummy tuck at this point is justified. I suggest you continue following up with your provider and you may want to consider scheduling a few in person second opinion consultations with other plastic surgeons in your community. It’s important to recognize there are significant differences in outcomes, depending on both patient, candidacy, and provider selection. Best, Mats Hagstrom, MD
Helpful