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

Thank you for your query about how to manage a lower abdominal bulge that has developed two years following a tummy tuck and liposuction.

Based on the details and photo provided, several factors could contribute to this issue. If the bulge appears intermittently, a hernia might be a possibility, which should be evaluated through physical examination and potentially an ultrasound.
Given your history of liposuction, it's less likely that the bulge is due to excess fat. The absence of skin wrinkles in your photo also suggests that excess skin is not the primary concern. A more probable cause seems to be the laxity in the rectus abdominis muscles, leading to abdominal protrusion.
My recommendation is to consider a revision of the tummy tuck. This would involve revisiting the previous incision and tightening the rectus abdominis muscles. Depending on the degree of muscle laxity, the insertion of mesh might be necessary to ensure a flatter abdominal profile. Additionally, any residual excess skin should be removed during this procedure.
In conclusion, a revision tummy tuck, focusing on the rectification of muscle weakness, seems to be a suitable approach to address your lower abdominal bulge.
Wishing you the best in your pursuit of an optimal solution.
Sincerely,
Dr. Katzen

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

An exam would be needed to know for sure, but from the photo it appears you may have a little excess skin. This would need to be addressed through excision. If the area is fat, localized liposuction should improve the result.

An examination is needed to be certain. If it is residual skin, it can be excised again like a mini mini tuck. If you have residual fat, you can have more liposuction. Just based on your photo, it looks more like skin.

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