Is this a failed muscle repair or swelling? What do I need to do to fix this? (Photo)

Question

Had my original surgery 10/29/23, was swollen but flat initially. Currently look like in the pictures. Is this a failed Mr or swelling? Do I need more lipo? I'm going in for a revision on Friday and my doctor believes I only need some mr tightening and fixing dog ears and minor revision to belly button. Will MT tightening resolve the bulge or do I also need to ask for lipo?

Ajaya Kashyap, MD · Answer

Thankyou for your query. It is difficult to say if there is adequate muscle repair or not from photographs alone. Your surgeon can check both the repair and also the presence of any superficial fat in your abdomen. If there is intra-abdominal fat, it can not be removed with liposuction. Your surgeon can check that out. Please get a second opinion, if in doubt. All the best!

Leila Kasrai, MD, FRCSC · Answer

Without an in-person assessment, it would be difficult to say whether this is caused by excess fat, failed muscle repair or something else. You did mention that you were flat initially, so it might not be excess fat. Please trust your surgeon as they’re more knowledgeable of the specifics of your situation.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether your abdominal bulge is due to a failed muscle repair or residual swelling after your tummy tuck. Based on your history and the provided timeline, it is difficult to determine the exact cause without a thorough in-person examination, comparison to pre-surgery images, or imaging such as an MRI. However, I can provide some insight into possible causes and solutions.

In many cases, a persistent bulge months after a tummy tuck may indicate a compromised or incomplete muscle repair rather than simple swelling. If your plastic surgeon has recommended additional muscle tightening during your revision, this suggests they suspect the muscle repair may not have been as secure or strong as needed initially. If the abdominal bulge is due to intra-abdominal pressure from an enlarged peritoneal cavity—located behind the rectus abdominis muscle—then simply tightening the muscle may help but may not fully resolve the issue. In such cases, many experienced board-certified plastic surgeons would recommend reinforcing the repair with surgical mesh. This mesh can provide additional support to keep the abdominal wall flat and prevent further bulging over time.

As for liposuction, it is unlikely that additional lipo alone would resolve the issue if muscle separation is the underlying problem. Liposuction primarily targets excess fat, not muscle laxity or intra-abdominal pressure. If there are areas of fat that were not fully addressed in your initial procedure, lipo may provide some additional contouring, but it will not correct a weakened abdominal wall.

For the best long-term results, a combination of muscle repair and, in some cases, mesh reinforcement may be ideal. If you have concerns, it is worth discussing all of these options with your surgeon before your revision surgery.

Thank you for your question regarding whether you have a failed muscle repair or swelling and what can be done to correct it. If you have further concerns, consult an experienced, board-certified plastic surgeon with extensive experience in tummy tuck revisions.

Sincerely,
Dr. Katzen

Ira H. Rex lll, MD · Answer

It is not possible to determine if liposuction will help in your situation.  Only an examination would allow me to give you good advice.  Good luck with your revision.

Camille Cash, MD · Answer

The contour that concerns you is likely either from muscle repair failure or from visceral fat.  If it is muscle repair failure then a revision will correct the problem.  If it is visceral fat then only weight loss will improve it.  Visceral fat is the internal fat behind the muscle wall that can't be improved with liposuction or a tummy tuck.  Your surgeon will be able to help determine the cause with an evaluation.

Is this a failed muscle repair or swelling? What do I need to do to fix this? (Photo)

Answers (9)

Answer: Revision of your tummy tuck

Answer: Revision of your tummy tuck

Answer: Abdominal contour

Answer: Abdominal contour

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Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.

Is this a failed muscle repair or swelling? What do I need to do to fix this? (Photo)

Answers (9)

Answer: Revision of your tummy tuck

Answer: Revision of your tummy tuck

Answer: Abdominal contour

Answer: Abdominal contour

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.