I am 37 years old and had a circumferential tt with fleur de lis in April 09.At 5 months post op I expressed my dissatisfaction with the way my bb turned out and the lower abdominal bulge and upper abdominal fat/skin. My ps did a pubic lift, abd lipo and a belly button revision 6 mos ago. The bb revision did not hold and I still have the bulge (which is rock hard) and upper abd skin. PS said that he is afraid of tearing the fascia and said there is nothing more he can do. Opinions needed please
Loose Upper Abdominal Skin and Lower Abdominal Bulge Post-Tummy Tuck
Doctor Answers 2
Disappointing Lower Body Lift results - Surgeon's fault?
Regarding:"Loose Upper Abdominal Skin and Lower Abdominal Bulge Post-Tummy Tuck
I am 37 years old and had a circumferential tt with fleur de lis in April 09.At 5 months post op I expressed my dissatisfaction with the way my bb turned out and the lower abdominal bulge and upper abdominal fat/skin. My ps did a pubic lift, abd lipo and a belly button revision 6 mos ago. The bb revision did not hold and I still have the bulge (which is rock hard) and upper abd skin. PS said that he is afraid of tearing the fascia and said there is nothing more he can do. Opinions needed please"
Based on your appearance, I would assume that you lost a lot of weight and had a significant amount of hanging skin - both in the front and back. Your Plastic surgeon then performed a Lower Body Lift (IE Buttock Lift , Thigh Lifts and Tummy Tuck) using a Fleur de Lis in April 2009. You thought you should have been flatter / less flabby prompting your surgeon to do a Tummy Tuck revision (Pubic Lift, Belly Button Revision) and Tummy Liposuction in March 2010. You are still not happy with your tummy bulge but now have a hard bulge in the lower tummy.
As comprehensive as your description is, it still leaves out valuable data. Moreover, with but a single AFTER picture and no BEFORE picture it is hard to asses the extent of improvement or lack there of.
Skin that has been stretched to the point of cracking resulting in stretch marks is NOT normal. You can have the tightest Tummy Tuck which is still compatible with blood flow through the skin and not having wound separation after surgery and in a few months this skin gives and loosens to create loose skin again. This is a good reason for NOT doing long, Marathon body contouring surgeries with high risks for blood clots and pneumonias. By doing the operation in stages, we PLAN on going back and doing touch-ups should they be required as we do the next body contouring stage.
The BULGE - The thickness of the fascia below the belly button is much thinner than above. A a result if any muscle repair would fail (poor nutrition, coughing, straining etc) - it most commonly happens in the lower tummy. Unlike any of us on this panel, your surgeon was the only one there. If he feels strongly that the fascia cannot be made any tighter ("he is afraid of tearing the fascia"), I have to believe him. With the exception of using artificial meshes to TRY and tighten the lower tummy, which have their own complications and high costs, you may just have to accept this condition. Another possibility and not a good one at that is that the hard lump you are feeling is dead fat. The area of the inverted T scar carries the least amount of blood for a long time after the surgery. This is the Bermuda Triangle of Tummy tucks. If you recall, judging by your scar, the midline took a very long time to heal leaving you with an indented scar. The same process could have caused the fat to die resulting in a "rock hard" area. This area may have to be cleaned surgically if it begins draining or does not soften in the coming months.
Based on the limited information available to me, I do not think your disappointing result was the fault of your surgeon. To satisfy yourself, I would advise you to see several other Plastic surgeons and see what each has to say AFTER examining you.
Dr. Peter Aldea
Belt tummy tuck and fleur de lis
I beleive Dr. Aldea has provided an excellent response and I would agree with his assessment. Your result is quite reasonable for the condition and I beleive you have recieved a very acceptable outcome.
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