Do I need a revision? (Photo)

Based on your photos it does appear a revision would be helpful in improving your results. Excess fat and skin would be removed. You could add liposuction of the hips/flanks for further contouring. See a board certified plastic surgeon near you to learn more.

The most common reasons patient bulge after a full tummy tuck is the presence of excess visceral fat. This should be assessed during an in person consultation and patient should be told that visceral fat is an issue before they have surgery. Individuals who have excess visceral fat will not get a flat abdomen even with successful muscle tightening. Individuals who are obese and have excess visceral fat should consider losing weight before the operation in order to optimize their candidacy for the procedure. You can still improve on your outcome with the weight loss, which should reduce the amount of intra-abdominal or visceral fat.
Insufficient muscle tightening is also a possibility, but this tends not to be nearly as common as not assessing visceral fat Contant properly, and explaining the inherent limitation, that excess visceral fat causes on the potential outcome of the procedure.
Before even considering revision surgery, you should try weight loss, which will most likely improve your results dramatically.
Best,
Mats Hagstrom, MD