Is revision tummy tuck with it? I was left with a lower stomach bulge after my surgery (Photo)

Congratulations on your impressive weight loss! An in person evaluation is always best, but from your photos it appears that further interventions in the form of muscle tightening or liposuction would improve the contour of your lower abdomen. An exam is needed to determine what is causing the bulge that concerns you. Once that is determined, the proper option can be discussed.

Dear Crod11,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If a tummy tuck includes muscle tightening then it’s fairly uncommon to have a problem of bulging of the lower abdomen as a long-term consequence. typically muscle tightening is more effective on the lower abdomen and if patients have a problem with bulging after muscle tightening it’s more typically of the upper abdomen.
Without having been present it’s hard to know how the procedure was performed or the extent of muscle tightening. Really only your surgeon knows if and how much muscle tightening was done.
Reading your operative report could shed some light on the subject.
Typically patients who had previous pregnancies should have muscle tightening as part of a tummy tuck.
Patients who have not had previous pregnancies and have skin laxcity only due to weight loss typically don’t need muscle tightening and it is often better not to do muscle tightening if it’s not indicated.
Your plastic surgeon is correct to some extent that a normal and including attractive women’s torsos should have a small bulge at the lower abdomen and that area being flatter than the upper abdomen does not look good or normal.
Obviously it’s a matter of extent and if the abdomen bulges significantly it will look better if it doesn’t.
Bulging of the lower abdomen can be due to lack of muscle tightening, shape of the pelvis and thickness of subcutaneous fat. Skin laxity can also contribute but is unlikely after a tummy tuck.
To get a quality assessment I suggest getting a few second opinion consultations. Second opinion consultations should be done as in person consultations because they require an examination. In your case an examination should be able to differentiate if the bulging is due to subcutaneous fat, skin laxity, muscle separation or pelvic shape or a combination.
Surgeons and willing to consider revisions can be a tricky situation and it may not be in patient’s best interest to force or demand a revision if the surgeon doesn’t feel it’s indicated.
That said some surgeons need a little more motivation or being poked at a bit to motivate them enough to do the revision.
Sometimes paying a reasonable amount of money for revision surgery may be appropriate if the original procedure was done in a competent manner.
Most plastic surgeons will do revisions without adding a surgeons fee but ask patients to pay for anesthesia and facility fees as a reasonable way of managing revision surgery.
Whether revisions are indicated or not depends on if the procedure could’ve been done better by the surgeon or by other surgeons. Obviously this becomes subjective to some degree and each provider will have their own threshold for revision surgery.
All plastic surgeons should do a certain percentage of revision work or there’s simply not aiming for the best results.
Surgeons would never do revisions are not leaving patients with the best potential outcomes and surgeons who do revisions frequently may be lacking in inherent skill and experience for the primary procedures.
Sometimes discussing your overall experience in a professional manner and that you are willing to share your experience and public forums can motivate providers one way or the other. Many surgeons will step up to the plate if they are concerned that patients will write a bad review.
Likewise it may be generous to offer writing an excellent review on multiple forms if the surgeon steps up to the plate and goes beyond basics to make sure the patient is well cared for.
Be careful that the discussion of writing positive or negative reviews does not come across as a threat. Most professionalism and communication will serve you further than getting emotional about it.
It’s also reasonable to discuss the outcome in regards to finances and some surgeons may be willing to give a certain refund if they acknowledge that the outcome is less than what they had anticipated or expected. refunds are probably not that common but they definitely happen and getting a refund is best done through careful professional negotiations.
Getting angry and making people defensive will not serve your cause.
People are people and surgeons just like patients come in a variety of personalities styles and types.
My best suggestion for you is to get a copy of your before and after pictures and a copy of your operative report. That will let your surgeon know you’re most likely seeking second opinions and may help motivate them to care for you. If not that is useful information to bring with you for proper a second opinion consultations.
Good luck in working out a solution hopefully one that works for everyone.
Best,
Mats Hagstrom MD