Should I get a TT revision for my extra skin over my incision and fat, bulging pubic area? (Photo)

I'm 4 months post op tummy tuck with muscle repair and lipo. I have a little skin that hangs over my incision scar on my sides and in the center of my belly. Also right below my incision, my public area bulges out. It's fatty, jiggly and poofy. It doesn't look normal to me or am I being too picky?

Doctor Answers 4

Do I Need A Secondary Tummy Tuck To Get Rid Of the Skin Overhang At My Suture Lines?

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Congratulations on what appears to be an excellent tummy tuck.  You have a well done belly button correctly positioned, the incision above the mons pubis is below the top of your pre-existing pubic hair, and the lateral wings of your abdominoplasty incision are kept low so as to be covered by a low rise bikini bottom.

You stated you had liposuction along with your tummy tuck but you didn't state if it was done on the abdomen or flanks or both.   If you were my patient, like most plastic surgeons, I would liposuction the flanks at the same time as the tummy tuck, but I personally do not liposuction the abdomen at the same time.  I would wait until a second surgery which you are now ready for.  I would allow 90 days to pass, letting the swelling subside, and allowing what is known as the delay phenomenon to occur.  This delay phenomenon, after a well done tummy tuck, changes the direction of blood flow in the abdominal wall from vertical (i.e. coming from the abdominal muscles) to horizontal (i.e. coming from the flank tissue).  This horizontal blood supply allows a much more aggressive liposuction, therefore giving you less residual abdominal fat and pretty much skin with subcutaneous fat on muscle. 

The skin overhang that you noticed at your suture line is due to a thicker skin flap above the suture line and a thinner skin flap below the suture line.  Many expert plastic surgeons sculpt these upper flaps in an attempt to match the thickness of the lower flaps.  However, even the best plastic surgeons get upper flap overhang at times.  Again, if you were my patient, I would do a tummy tuck, hopefully as good as the one you received thus far, followed in at least 90 days by aggressive liposuction that would even out all uneven flaps, and of course, get rid of the puffiness that you are unhappy with at the mons pubis.  

Cosmetic plastic surgery is a process and not an event.  At this point, I would ask for a second consultation with your personal plastic surgeon to discuss the possibility of a liposuction to refine the excellent tummy tuck you already received.

Should I get a TT revision for my extra skin over my incision and fat, bulging pubic area?

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It is still too soon to consider revision surgery as you will still have some swelling and scar tissue. The public area may be eailty addressed with liposuction but again, wait a few more months before sonsidering revision surgery. Best wishes. Dean Vistnes. 

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 51 reviews

There is still swelling four months after a tummy tuck.

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There is still sizable swelling so I wouldn't rush to do anything. The stretch marks that remain do compromise the final result. If the Mons is to thick this can be easily suction with local anesthesia.

Unhappy with tummy tuck healing.

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Thank you for asking about your tummy tuck and liposuction.
Things may improve over the next few months but -

  • The lower body skin looseness may need tightening if things don';t improve with all swelling gone.
  • The prominent tissue in the pubic area may need liposuction.
  • Discuss with your surgeon and have a plan as to what might be needed and when it might be done.

Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.