What can I do to correct a bulge after liposuction? (photos)

Question

Prior to getting a bbl I had a flat stomach with no bulge. I gained weight just to get a bbl and a few months after I got the surgery, my stomach looked like this. I currently still have a small bulge but it’s now soft and is a “roll” when I wear pants. When I lay down it’s flat. Can I fix this? It really bothers me. Especially because I didn’t have it before I got the surgery.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for providing detailed background and images. It seems like the bulge you are experiencing might be due to the accumulation of visceral fat—fat stored in the peritoneal cavity behind the rectus abdominis muscle, likely due to weight gain for a BBL.

Given this, additional liposuction may not be beneficial as it could potentially worsen the condition. The issue here seems to be the visceral fat and weakened abdominal muscles, not subcutaneous fat, which liposuction targets.

For a surgical approach to address the muscle laxity, a rectus abdominis muscle repair could be considered, either as an isolated procedure, possibly even endoscopically, or combined with a tummy tuck, depending on a detailed physical examination.

If surgery is not a preferred option, adopting a ketogenic diet along with intermittent fasting exceeding 14 hours could also be beneficial to reduce visceral fat.

I hope this provides clarity on addressing a stomach bulge post-liposuction. Wishing you all the best in finding a suitable solution.

Chet Mays, MD · Answer

Thank you for your inquiry!  Liposuction of the abdomen is an option.  But there are other options to consider depending on the laxity of the skin and the amount of fat you would want removed.  We would love to sit down with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your options.

Babak Moeinolmolki, MD, FACS · Answer

Following your liposuction you have developed skin looseness. the best way to fix this is to have a revision liposuction and tighten skin so that you can eliminate skin laxity that is causing it to lean over when you are standing. Pleas consider a virtual consultation with a liposuction and Renuvion J plasma expert.

John Michael Thomassen, MD · Answer

You probably need another round of liposuction to even out the bulge.  Depending on the size it can be done under local anesthesia.

Zoran Potparic, MD · Answer

In most patients this kind of bulge is due to localized collection of fat that was not removed in the course of liposuction. However, in a very few patients, bulge can be result of a weaknes of the abdominal wall, which may have not been observed before liposuction. This is always best to discuss with your surgeon or seek in person second opinion by a board certified plastic surgeon in your area. Hope this helps.

Connie Hiers, MD, FACS · Answer

You need to be examined to see if this is just fat or if it is something more like a hernia. Please let your surgeon examine you.

Bruce K. Smith, MD · Answer

A good assessment and proper recommendation can only be made with a consultation in person, but it appears that the contour problem could be improved with additional liposuction. There is a chance the bulging is caused by intra-abdominal fat and that would be a much more difficult problem to treat. An examination in person could help you determine the best course.

Sean Satey, MD, FACS · Answer

Based on the pictures alone, it's hard to discern whether you have a diastasis recti versus uneven fat removal from your previous lipo procedure vs skin redundancy of the upper abdomen (from aggressive fat removal) which is leading to what is called "umbilical hooding" or excess skin above the belly button. The best way to test these is- if it is a diastasis recti, you will be able to let your belly loose, and suck it in, and see a significant change in size and shape of your abdomen. The treatment for this is an abdominoplasty, or a tummy tuck with muscle repair. The second, if you pinch all the fat of your abdomen and work your way down, you will notice uneven pinches of fat between your index and thumb fingers. The solution to this is revision VASER assisted liposculpting. The third can be tested by pulling the skin of your upper abdomen upward toward your chest. If everything smoothes out, it is a skin problem. The solution to this is also an abdominoplasty, or tummy tuck, which will eliminate the loose skin of your upper and lower abdomen. Hope this helps. Best, Dr. Sean Satey, Beverly Hills, CA.

Douglas Taranow, DO, FACOS · Answer

Jean,
I have a bunch of questions.  First, did your surgeon only suction the lower abdomen?  If so, then the bulge may be due to a fat deposit.  If the entire abdomen was suctioned, then it is either fat left behind, or possibly the muscle underneath curving out (less likely by looking at your photos).  
I would have to perform a physical exam to more accurately answer your questions.
Best wishes,
Dr. Taranow

Camille Cash, MD · Answer

I encourage you to return to your surgeon for an evaluation.  If the bulge that concerns you is fat then it is usually addressed with liposuction.  Small areas can often be corrected under local anesthesia in the office setting.

What can I do to correct a bulge after liposuction? (photos)

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