Flabby and Fat Abdomen After Tummy Tuck

Question

I had a full Tummy Tuck almost 3 months ago. I am in excellent health, don't smoke, never had children.  When sitting, my belly rests on my thighs. When bending, my stomach hangs. When standing, my tummy looks fat and paunchy. I can pinch chunks of skin (fat?) above and below my belly button. Not tight at all.  This doesn't seem normal to me after Abdominoplasty.   My doctor says I'm near my final results and not swollen. He says I need Liposuction to eliminate the flab (fat), which I think may make my stomach look worse.  Opinions or suggestions please.

Armando Soto, MD, FACS · Answer

Hi there-
Of course without examining you it is difficult to say for certain, but from the photos you posted and your description of your complaints, I think that what your surgeon told you is right on...
It sounds like the problem was with your expectations from your tummy tuck... even the best performed tummy tuck will not reduce the thickness of the fat on the abdomen, as this would require liposuction- which is generally NOT thought to be safe to do at the same time as a tummy tuck. The goal of the tummy tuck was to tighten your muscles and remove the excess skin- if there is fatty tissue in the thickness of your abdomen, this will need to be dealt with through liposuction- usually 6-8 weeks after the tummy tuck.
It also looks like you may have some fatty tissue collected inside your abdomen, where your intestines and other organs are (this is called visceral fat, as opposed to the subcutaneous fat that we remove with liposuction)- this is not possible to reduce through any plastic surgery, as doing so may endanger your organs and safety.
Go back to your surgeon, explain your goal, and follow his/her recommendations... I don't think there is a problem with your tummy tuck- you just need some liposuction to put the finishing touches on your result.

J. Timothy Katzen, MD, FACS · Answer

Hello atlantaapplepie. Thank you for your question regarding the appearance of your abdomen after a tummy tuck. Based on your description, it sounds like you are experiencing more laxity and fat retention than expected post-abdominoplasty.

Firstly, it's important to note that every patient heals differently, and the final results of a tummy tuck can take up to a year to fully manifest. However, given that you're already three months post-op and noticing significant issues, it might be worth considering additional treatments.

VASER Hi-Def liposuction can be an effective solution in your case. This advanced liposuction technique specifically targets and removes fat with precision, which can help create a more defined and toned appearance. We often perform VASER Hi-Def liposuction after tummy tucks to address any remaining fat and to achieve a more sculpted look.

However, based on the photo provided, it is not possible to clearly see your results. What you're describing sounds like you have excess skin and fat, which liposuction alone wouldn't fully address. Liposuction is excellent for removing fat, but if there is significant excess skin, it may require additional skin-tightening procedures.

There's also a possibility that the bulging you’re experiencing is due to visceral fat, which is fat around the organs. Visceral fat cannot be removed with liposuction and requires weight loss through diet and exercise.

It's understandable to have concerns about further procedures, but liposuction can actually enhance the results of your tummy tuck by addressing areas that may not have been fully contoured during your initial surgery. Additionally, skin tightening procedures can be combined with liposuction to help address any laxity and improve overall skin tone.

I recommend discussing these options with a board-certified plastic surgeon who has experience with VASER Hi-Def liposuction and post-tummy tuck revisions. They can provide a thorough evaluation and create a tailored plan to help you achieve the results you're looking for.

Good luck, and I hope you find the best solution to achieve your desired outcome.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Richard J. Bruneteau, MD · Answer

When plastic surgeons perform abdominoplasty, safety is
always their first priority. For this reason, they sometimes make compromises
that increase the safety margin and minimize the potential for complications. This
might involve minimizing tension on wound closures to avoid wound breakdown or
performing liposuction as a secondary procedure to avoid damage to the blood
supply of skin flaps. For these reasons, it’s important for patients to have
realistic expectations following this type of procedure. Sometimes a secondary
procedure just can’t be avoided.It’s
difficult to make treatment recommendations without performing a physical
examination. With that said your history and pictures demonstrate residual fat
in your abdominal wall as well as minimal skin laxity. It’s important to
realize that the skin always loosens when patients flex their abdomen when
sitting or bending over.Once
healing is complete, you might be a candidate for liposuction or resection of
additional skin. It’s important to discuss these issues with your plastic
surgeon. Your surgeon should be able to formulate a treatment plan that
addresses your concerns.

Jaime Perez, MD · Answer

Hello, It is possible that you may need a second stage to your procedure. There is a maximum amount of fat that is allowed to be removed in every state, which is why your surgeon probably didn't over do it. I would recommend you meet with your surgeon and see what he suggests. From the sound of it and your pictures you may need a second procedure of liposuction to remove fat and shape your torso. Best of luck.

Robert Vitolo, MD, FACS · Answer

Sometimes it is necessary to have an additional procedure such as liposuction after an abdominoplasty. We sometimes call these staged procedures. In your case your results look as if additional liposuction is needed. I would recommend that you visit your surgeon and ask him for his opinion.

Flabby and Fat Abdomen After Tummy Tuck

Answers (5)