Hernia? After Full Tummy Tuck? (photo)

Thank you for your question. It is very unlikely to develop a hernia in the upper abdomen following a tummy tuck. It is more likely that the muscle repair separated or you have a small collection of fat or fluid following the liposuction. This can be sorted out with an ultrasound or scan of the abdominal wall if it does not resolve on its own. Good luck.

There are several possible explanations for your plight. But speculating in the absence of a physical examination is tough. Disruption of the plication is the most likely cause if you exclude old hematoma and seroma. But I would 't treat this like a ventral hernia and I wouldn't begin to discuss mesh unless you're sure what's going on. I would do a carfull physical exam first and if there's doubt, I would suggest a CT scan. Best of luck to you!

Is extremely unlikely that you have a hernia in the area pictured. The problem should be investigated even if treatment is not desired. There may be something amiss with the initial repair or there may be something else going on unrelated to the previous abdominoplasty.

As has been posted, online consultants cannot tell you what you have. A bulge is simply a weakness. A hernia is a true defect in the abdominal wall through which abdominal contents push. Hernias typically require treatment while bulges do not. That location is much more commonly a bulge unless you've had a previous incision. A CT scan can help distinguish between the two. Either way, the area won't simply "go away" with repair. An internal mesh would treat both issues as it places a barrier underneath the abdominal wall to prevent the unsitely show of a bulge or repairs the separation in a hernia. It might be a good idea to have your two surgeons talk with each other as to how to proceed.

Thank you for the question and pictures. Online consultants, without the benefit of in-person examination, will not be able to provide you with a precise enough diagnosis/advice. At this point, you are aware of the differential diagnosis;  if still in doubt, seek in-person evaluation by well experienced board certified plastic surgeons in your area. Careful physical examination is likely to be all you need to make the diagnosis.  Rarely, imaging studies may be helpful.

 Best wishes.

This would not be a common site for a hernia unless you had one there before, so more likely is loss of the diastasis correction. I can't tell from the question if there is mesh present, or if it is being suggested. The presence or absence of a hernia can be more definitively determined by a CT scan, and often by an ultrasound exam. Although I would normally side with the plastic surgeon for this particular issue, I would get a study. If a hernia is present, the GS might be the better surgeon for a repair, except that he may be more likely to use a direct incision rather than the TT incision. So, I would get the scan, get two opinions (or more) and choose among the options. 

All the best. 

I put my money on the plastic surgeon.  If you didn't have a true hernia before your tummy tuck, it is very unlikely that you have developed one afterward.  Most likely you have a recurrence of your diastasis recti, which is the stretching apart of your abdominal muscles. The fact that it became more apparent after liposuction supports this idea too.  As it has been present since your tummy tuck, my suspicion is that your initial repair either wasn't done optimally, or it didn't hold.  If you are going to undergo another procedure to correct this, I'm not sure I would jump straight to mesh, because the only way that I have seen mesh work in this type of situation is when it is overlaid on the entire abdomen, essentially from ribcage to pelvis and from side to side.  This is a huge undertaking and generally avoidable with a good two layer plication of the muscle layer in the midline.  If that fails, I would consider mesh, but given the potential problems with mesh and the less than 100% probability of its success, I would make it only a last resort.

with an ultrasound it would be the diagnosis if it is not a seroma then would it be no precisely an herniae if not a protrosion of upper rectus abdominal muscles by mesh graft reeleased,  if it is the last one problem  TT should be  revised.

puede ser una de 3 cosas, un seroma, una protrusion, no precisamente una hernia se podria  diagnosticar el problema  mediante un ultasonido si fuese una protrusion habria que volver a realizar el TT

Very simple diagnostic tool is a scan to see if it is a hernia. Than you can determine what course of surgery you need. 

The main causes of lump or bulge in the upper abdomen after a tummy tuck with liposuction are usually hematoma, seroma, fibrosis (due to a calcified hematoma), capsular contracture (due to prolonged and  undrained seroma ), or diastasis by rupture of plication sutures.
A physical examination is required to clarify if it is a hernia as this is extremely rare unless there was  a hernia prior to surgery, in this case would be a recurrence of the hernia. Anyway whatever  can be  corrected satisfactorily by a revision surgery, a mesh may be or may not  be  necessary  if there is a hernia on the  base of  the  physical  findings.