Round tummy after TT & MR

Hello, and thank you for your question regarding why your abdomen still appears round 9 months after your tummy tuck (TT) and muscle repair (MR). Let’s explore the possible causes.

By 9 months post-op, most of the initial swelling from surgery should have resolved, although residual swelling in some patients can persist for up to a year. However, if your abdominal shape hasn’t changed since the third or fourth month, swelling is less likely to be the cause.

A rounded appearance can result from several factors:

Muscle Repair Concerns: If the muscle repair was not adequately performed or has partially separated, this could leave the abdominal wall weaker and unable to provide the flat appearance you expected. In some cases, patients with significant muscle weakness or hernias may require the addition of mesh to support the abdominal wall.

Visceral Fat: The shape of the abdomen is also influenced by internal (visceral) fat, which lies behind the abdominal muscles and around your organs. If visceral fat is present, no amount of muscle tightening or external fat removal will completely flatten the abdomen.

Bloating or Gastrointestinal Issues: Chronic bloating caused by diet, gut health, or conditions like irritable bowel syndrome (IBS) could also contribute to a persistent round appearance. If bloating worsens after meals or varies throughout the day, this may be a factor to explore with a gastroenterologist.

Skin and Fat Distribution: Although you mentioned that you’re slim, minor skin or fat laxity above the muscle could also contribute to the shape. In some cases, additional liposuction or refinement may help.

If the roundness is truly caused by a failed or incomplete muscle repair, revision surgery may be necessary to address the issue. I recommend consulting with a board-certified plastic surgeon for a thorough evaluation, which may include imaging like an ultrasound or CT scan to assess the muscle repair and abdominal wall integrity.

Your results should align with your expectations, and addressing these concerns is essential to your overall satisfaction.

Sincerely,
Dr. Katzen

From the photos it appears you may have muscle wall laxity or perhaps visceral fat. This is the fat behind your muscle wall that surrounds your organs. It cannot be addressed through a tummy tuck or liposuction. If it is bloating, diet changes or a visit to a GI physician may help. I encourage you to discuss your concerns with your surgeon to determine next steps.