How can I treat lower abdomen bulge 2 years of tummy tuck and lipo 360? (Photo)

Based on your photos you have a little vertical incision and a bit of residual saggy skin. So it will be needed a little skin resection, nothing serious or extensive.
Be encouraged!!
Dr. Cárdenas

Making an assessment regarding the appearance of someone’s abdomen is fairly straightforward. There are generally four tissue variables that determine what the abdomen looks like. In other words, if somebody doesn’t like the way, their belly looks it is always because of one or more of four different tissue reasons. The four variables that determine what the abdomen looks like or the following.
1) skin laxative typically due to previous pregnancies for weight loss2) excess subcutaneous fat3) muscle separation from previous pregnancy4) excess visceral or intra-abdominal fat.
The aesthetics of someone’s abdomen can almost always be related to one or more of the four variables whether someone has had previous surgery or not. In your case your muscle wall is flat, so muscle separation is not an issue. You’ve had your fat removed so obviously subcutaneous fat is not causing the problem. There’s no fat causes bulging of the entire abdominal wall, and would not improve when you’re laying on your back, so the problem is most likely flight skin laxity of your lower abdomen, despite having had a full tummy tuck. I’m guessing revision of your tummy tuck, removing another inch of skin of the lower abdomen only would do the trick. This can probably be done as an awake procedure using local anesthesia in the office.
To assess if skin is contributing, try pulling on the skin until it’s under tension and see if that improves your contour.
A sufficiently talented plastic surgeon should be able to easily differentiate between each of these four variables. This stuff isn’t rocket science. The variable that’s most commonly missed, is access, visceral fat, causing bulging of the abdomen after a tummy tuck, but I don’t think you have a problem with visceral fat.
I’m wondering if you’re happy with a Liposuction result?
Good luck,
Mats Hagstrom MD