Is this bulge normal? I was told it by my surgeon it was visceral fat (Photo)

Hello
It has been more than a year since the tummy tuck. If visceral fat was present and proper muscle plication was done during the surgery, shortness of breath could occur post-op. If this didn't happen, it could mean that muscle plication was not performed, was done loosely, or the sutures used for muscle plication may have torn the muscle, causing this type of appearance. In such cases, this type of swelling can be seen in the upper abdomen.

Thanks for your question! It would be really helpful to see pre-op photos. That is the best way to determine what we are looking at now. I might also suggest getting a second opinion in-person. Good luck!

Thank you for your question regarding the bulge you've noticed after your mommy makeover. Given your history and the photos you've provided, it’s important to consider a few possibilities.

First, it's crucial to confirm with your plastic surgeon whether they performed rectus muscle repair during your surgery. Muscle repair involves suturing the rectus abdominis muscles, running from the bottom of the sternum to the top of the pubic bone. This is typically done with permanent sutures in two layers to strengthen the abdominal wall. The sharp pain you experienced, followed by the appearance of the bulge, raises the possibility that some of these sutures may have been disrupted. If the muscle repair was compromised, it could explain the bulge you are seeing.

Alternatively, as your surgeon mentioned, the bulge could indeed be due to visceral fat, which is fat located behind the muscle, pushing the rectus muscles outward. This type of fat can create a protruding appearance in the abdomen, even after surgery.

To get a definitive answer, I recommend undergoing further evaluation, such as an MRI of the abdomen. This imaging can help determine whether the muscle sutures have been disrupted or if visceral fat is causing the bulge. If the issue is related to visceral fat, weight management could be part of the solution. In some cases, weight loss medications like tirzepatide or Zepbound might be recommended to help achieve your desired results.

It’s essential to follow your instincts and seek the necessary tests to clarify the cause of the bulge. I hope this helps address your concerns and guides you in the next steps.

Sincerely,
Dr. Katzen

Though highly unlikely, is is possible to tear a rectus repair. Your surgeon is right - the fullness does reflect deep structures - bowels, stomach, and fat. I you have a rectus repair failure, you will see a ridge along midline when you do a sit up. Another option is a CT to visualize the abdominal musculature. This is by no means a disaster - just get the information, and discuss with your surgeon if there is a recommended repair.

Hi from Istanbul. It is very hard to tell you if it is a visceral fat or a failure of the muscle repair.You should trust your surgeon during your follow up. If it was an excess fat liposuction could help to remove it and you should do abdominal work out and healthy diet to reduce the bulge.

Very hard to know if I can't examine area. Sometimes the rectus repair can fail in a certain area and the bulge can occur. If your surgeon did not feel a separation, it can be visceral fat. If it persists, see your surgeon again.Hope this helps.

Difficult to tell exactly what is causing the bulge. In general, that is the hardest area of the rectus diastasis to tighten due to the proximity to the ribs, therefore your surgeon is correct that this could be visceral fat you are seeing. Other photos, such as a front view, would help in this evaluation. Ultimately, some additional liposuction may help, but typically the only way to tell would be an in person physical exam.

Dear Nicky1526,
I understand your concern. Based on your photo, there is a chance that it is visceral fat. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

If it is fat in front of your muscle, liposuction cn remove it. If it is fat behind the muscle, diet can help. if the sutures were torn apart, the muscle may need to be repaired or later you could try noninvasive EMSculpt.

The contour that concerns could be caused by visceral fat. This is the fat behind the abdominal wall that surrounds your organs. It is not addressed through a tummy tuck or liposuction. However weight loss will improve it. If you had full abdominal wall correction it also could be related to failure of the repair. I've included a video that I hope you find helpful.