Why do I have a shelf/bulge/roll after TT with MR? 4 mo P.O., it seems to be getting larger with time? (Photos)

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from a revision surgery with lowering of your scar and thinning your abdominal flap.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.  
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

There are a multiplicity of reasons for your issue including residual fat requiring liposuction, seroma or fluid collections that occurred after drain removal, an imploded scar due to closure issues and or wound healing issues.  A revision would help.  If I were doing it, I would use liposuction to smooth things out, along with a scar revision to lower the scar.  Touch base with your surgeon.  

I think you are appreciating  the bulge is getting worse as the swelling is coming down and so you see a difference between the  thickness of the upper flap and the lower area around your Mons. 
I think you would benefit from a revision and thinning of the upper flap  and lining up the  upper part of your abdominal area and the lower part of abdominal area better.You could likely have removal of the vertical scar completely as well.  Usually if you have a tremendous amount of excess skin that a vertical incision is not required.
It's hard to say just based on picture, I would have to see what the tension of your skin is, but I think you definitely would be a candidate for a revision  and excision of more skin and better alignment of your abdominal flap with your Mons area. I would suggest going back to your surgeon and talking with him or her and seeing if you would be a candidate. 

This looks like a bit of fat in the area.  A gentle liposuction can help.  If it is fluid then drainage can help with this also.  You would need a physical examination.

If you had as you said extreme amount of loose skin it is not clear why you would need a vertical scar or why your scar is higher than expected.  From your pictures it appears you still have some laxity which mean that your scar could be lowered some more, this would help with the bulging, also some minor liposuction may be added.  When doing tummy tucks on people who have had a large weight loss the skin will frequently relax post operatively in spite of being pulled tight in the operation and this can give you some laxity and bulging that develops over time during the post operative period, not sure if this would apply to you.  Follow up with your surgeon with your concerns and get his or her suggestions.

It could be caused by several different things. It could be swelling, asymmetry of the subcutaneous fat layer on the two sides of the incision, scarring, fluid, to name a few.  You would have to be seen in person.

If you had a lot of loose skin before your tummy tuck, it’s hard to understand why your incision wasn’t play lower and the need for a vertical incision. The reason I mention this is it makes me question the technique used which may also relate to why you have a bulge. If it is enlarging, and your weight is stable, most likely you are collecting fluid in that area. You really need to go back to your surgeon and have this sorted out.  Without an exam, it’s difficult to tell, but if you were in my office I would likely recommend  redoing the tummy tuck in order to lower the incision and address what is likely a mature sermon cavity. Don’t let it get any worse. Go back to your surgeon.