Round tummy after TT & MR

It would help to see your preoperative photos, but you seem to have a very nice abdominal contour. Some extra fullness may be do to not being tightened to your expectations or your tissues not being able to withstand the tension on the sutures. Also, the amount of intra-abdominal fat sometimes limits tightening as much as you may prefer and have expected. You should speak to your plastic surgeon about this and review any options. Sometimes your body shape just does not allow for more tightening than this. Mesh generally is not used in these situations.

This could be caused by a variety of factors, such as bloating, excess visceral fat or abdominal muscle separation. You may want to consider speaking with your primary care physician about your concerns or returning to your surgeon.

Dear Beauty666,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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

This can be a result of insufficient liposuction or muscle repair. It can also be because of muscle relaxation after the surgery due to absorbable stitches. If there is right amount of fat under the skin I believe that this is due to repair method. For a flatter tummy you would need to have a muscle repair revision.

From the picture you have had a very good result and the roundness is very likely coming either from lake of muscle tone (surgery cannot address that. Only yourself can improve it by using your muscles, toning and exercising) or the shape of your pelvis (surgery does not address that).

I would go to your medical doctor and check for boating. The most common cause of bloating are food allergies. Your physician can test you for this. Surgery, of course, will not address food allergies and bloating.

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.