Do I Need A Revision - 1 Year Post-op, Belly Button is Protruding (photos)

Generally speaking there are three reasons why someone may have a bulging upper abdomen after a full tummy tuck.

The first reason is excess visceral fat. Muscle tightening with a tummy tuck reduces the intro domino cavity and the volume needs to go somewhere. Lower abdominal muscle tightening is usually very effective and the bulging because of this often displace in the upper abdomen.

Weight loss will reduce visceral fat and if the condition improves with weight loss then visceral fat is probably at least part of the explanation.

The second reason is individuals who are barrel chested or have a sternum that sits significantly forward in relationship to their pubic bone.

Muscle tightening typically creates a beeline between the rib cage and (the sternum typically sits in front) to the pelvis (pubic bone often represents the front of the pelvis). In individuals this chest is more barrel shaped or round with forward projection surgeons should predict that the upper abdomen is likely to bulge as a result of aggressive muscle tightening. One way to compensate for this is the back off and do less muscle tightening of the lower part of the abdomen.

The third potential reason is simply less than ideal muscle tightening especially overly aggressive tightening of the lower abdomen. Almost always one or both of the above variables are the underlying reason.

One way to assess if the problem is caused by excess visceral fat it’s just see how much pressure it takes to hold the abdomen flat where is bulging out.

If it takes a fair amount of pressure to push your abdomen flat and doing so creates a sensation of having a full abdomen with difficulty taking a deep breath then visceral fat may be the primary cause.

Without an examination is difficult to give you a better assessment but almost always this comes down to visceral fat for the relationship between the rib cage and the pelvis(Plus minus if this was compensated for during the procedure)

Different plastic surgeons may have different opinions on this. This is just based on my experience.

Best,

Mats Hagstrom MD