There's hope if you choose the right surgeon
Congratulations on your pregnancy. Usually we sort of hate to see the result of a good abdominoplasty come undone but in your case maybe not so much since you were dissatisfied anyway. Secondary abdominoplasty can be a very challenging procedure so I would suggest that you find a plastic surgeon who has a special interest and experience with this. The issue is not so much whether the muscles have spread again, but whether the skin stretches out enough to basically re-do the whole procedure. The skin above the belly button has to be able to expand all the way down to the pubic area. And making a nice belly button is a bit of an art form so ask specifically about that in consultation. You may have a hernia at the belly button so that shoud be evaluated too.
Your case should be do-able, but...
It would have been better if you hadn't become pregnant after your tummy tuck, but maybe you did not know this. Having had surgery before your pregnancy will likely stretch things out to the point where additional muscular repair may not "stick" so well. I would wait until decide you have finished childbearing and get a copy of the operative note your first tummy tuck surgeon produced at surgery and take it with you to consultation as you evaluate your options.
It might be possible to do as you describe for your previous results and post-pregnancy belly, but it might also require an additional lower midline vertical scar.
Your situation is fixable.
It is hard to tell for sure without examining you. However, what you describe is not uncommon. I often have patients come in for consultation who have had abdominoplasty done elsewhere who have similar complaints to yours. In many cases they actually had a "mini-abdominoplasty" which did not address their upper abdomen, but made their lower abdomen very tight - giving the strange look you are experiencing. After your delivery, at the time of your tubal ligation, it would be possible to do a revision abdominoplasty. At this surgery, the abdominal fascia can be evenly tightened and the excess skin excised. You should end up with a much more even and aesthetically pleasing result.
Hi there- In order to make a recommendation or discuss what might be possible, it would really be necessary to examine you- it sounds like you either had some form of a limited tummy tuck (like a mini-tummy tuck) or that your muscle repair above your belly button loosened somehow. I would wait until you are at least 6 months post partum from the current pregnancy, and then go see your surgeon again. After a careful exam, it may be that a revision will achieve your goals. Revision of abdominoplasty is possible and can yield significant improvement.
You should be able to get improvements from a redo tummy tuck
Given the fact that you have had 2 pregnancies after a tummy tuck, you should be able to get substantial improvement with a redo tummy tuck. It should be a full procedure so the upper abdominal fascia gets tightened.
The results of the belly button depends on how you do it and some amount of luck.
Surgeon Research for the Revision
This is a great question to ask for all of those face torso appearance issues when pregnant after a previous procedure. Agreed that the little contouring with your procedure could be touched up later with liposculpting of your entire torso/core, or another cleaner abdominoplasty. This would likely provide better results for shaping and trimming and hopefully help meet the initial goals of final results that you had when entering this procedure. See a board certified PS to discuss a procedure and the final sculpting that may help you become satisfied.
Complete recovery from pregnancy--very important first step.
virtually impossible to make a treatment recommendation until you’ve completely
recovered from your pregnancy.After
pregnancy you will probably have recurrent weakness of your muscles and
redundant abdominal skin as well.
Under these circumstances you will
probably be an excellent candidate for a revision abdominoplasty.At that time muscle repair can be undertaken
to further tighten your upper abdominal wall and remove excess abdominal skin.
It’s important to discuss your
situation with a board certified plastic surgeon with experience in this
area.This surgeon should be able to
formulate a treatment plan that addresses your anatomic findings and achieves
your aesthetic goals.
Revision abdominoplasty should make the belly even again.
The first problem with what you’re describing is that a
tummy tuck, performed properly, should not have left laxity and unevenness
through the upper abdomen. It sounds like either an issue with the surgery or perhaps
only a mini tummy tuck was performed. In either case, revision surgery is
possible, as long as you find a skilled and experienced board certified plastic
surgeon with ample experience specifically in revision abdominoplasty. It’s definitely
a good idea to be sure you’re done having children before scheduling your
surgery, and to give your body at least six months to a year to recover from
childbirth. Above all, I encourage you to take the time to find the best
Revision of Mommy Make Over
I can think of three likely scenarios to result in what you describe: tight lower abdomen but bulging upper abdomen. This usually happens by either performing a "mini tummy tuck" that is only tightening the area just below the umbilicus or else disproportional tightening the lower abdominal muscles more than the upper ones, or a dehiscence (repair came apart) on the upper abdomen. When the lower abdominal muscles are tightened this displaces the abdominal contents towards the top causing it to protrude. In general, most cases both the bulging and your belly button can be improved but without examining you I cannot answer for sure.
Larry S. Nichter, MD, FACS