Boxy tummy tuck 6 months after surgery. Are these the final results? (Photo)

Liposuction or Tummy tuck with muscle repair will never eliminate the visceral fat which is the cause of your protruding appearance.
Plus you must understand that removing fat and skin with tightening muscles will never modify your bone frame which is wide on your chest and upper body, so your upper body width won’t reduce with any type of surgery. It will wey helpful if you remain with a BMI below 30 and closer to 25.
Be encouraged !! You can do it.
Dr. Cárdenas

Dear Diligent903564,

Thank you for sharing your concerns about the boxy appearance of your tummy tuck six months post-surgery, and for providing your history and photos.

Based on the images and your BMI of 28.32, it's evident that your abdomen remains distended, likely due to visceral fat situated behind the rectus abdominis muscle. This fat and the volume of your peritoneal cavity seem to be exerting pressure on the rectus muscle, causing the distended appearance.

To best address this, I recommend prioritizing diet and exercise. Adopting a ketogenic diet with limited carbohydrate intake might help reduce the size of your peritoneal cavity. If you need further assistance in this domain, consulting with your PCP could be beneficial; they might even consider prescribing Ozempic, provided you meet the criteria.

However, if dietary and exercise interventions aren't feasible or don't yield the desired results, there are surgical options to explore. Considering your abdomen has already undergone horizontal tightening, a vertical approach might be beneficial. There are two potential incision locations for vertical tightening: one running from the sternum to the pubic region, and the other located laterally, aligning with the natural position of your arms at your side. The former results in a fleur-de-lis pattern, while the latter is known as a vertical torsoplasty or hourglassing procedure. The vertical torsoplasty might enhance your waistline, and complementing this with fat transfer to your hips can emphasize an hourglass silhouette.

I hope this provides clarity regarding the appearance of your tummy tuck six months post-surgery and potential paths forward.

Wishing you all the best in your journey to achieving the desired outcome.

Sincerely,
Dr. Katzen

Although you do have swelling, it is a small component of issue, and most will resolve in another 6 months or so. The real problem is not the execution of the surgery either, it is the presence of fat in the intra-abdominal space where your organs live. This fat can only be reduced by weight loss, and when this happens you will be happier with your result

I cannot speak specifically to you as I don't know what you looked like before. What I can say is that some of us have a more boxy less curvy body type. Many women do not have a small waist and wider hips. This is called an "apple" body type. It can be genetic. We can have a predisposition to weight gain more in the middle than our butt/hips/legs. At 5'4" 165lbs you are carrying 30-40 extra pounds of fat. This fat may be intra-abdominal and cannot be removed with liposuction. Have you considered weight loss? Semiglutide weight loss shots are very popular right now if you need help getting some of that weight off. I think you contouring could be helped with a plug in you belly button to make it less of a slit and consider KT tape at the midline to pull that skin apart or laterally.

You have small hips and larger upper body and chest which is due to your bone structure and cannot be changed. EMSculpt could be done to help tone and build more abdominal muscle and help pull in your abdomen. Your abdomen does naturally curve out because of your back, and that is bone structure which cannot be changed. At 5'4", you still need to lose at least 40 pounds which will make your internal abdomen smaller. However, you are not built to be very curvy.

You will have some swelling present from your liposuction procedure. Most of that will be resolved by 6 weeks post op. It appears from your photos that the main issue may be visceral fat. This is the fat that surrounds your organs and is behind your muscle wall. This is improved with weight loss only as a tummy tuck or liposuction can't address it.

Plastic surgery results with the exception of rhinoplasty surgery. Are pretty much final at three months.
To make an accurate assessment regarding the outcome of a plastic surgery procedure, we always need to see proper before and after pictures. If you’ve had more than one procedure, then you should include before and after pictures for each of the previous procedures.
Based on the pictures you’ve included, you were not to ever get a flat abdomen without first losing weight. Considering that you’ve had previous Liposuction and It Sam attack your physiological weight is probably closer to 170 or 175 pounds based on the tissue that was surgically removed. Do you have a substantial amount of excess visceral organs, Rob, domino fat, and this should’ve been detected during your consultation explaining to you that weight loss is mandatory in order to get a quality outcome. The potential for quality results is still there but it’s going to require you to drop at least 30 pounds.
There are four tissue variables that determine what the abdomen looks like. The outcome of tummy tuck surgery is highly predictable based on having a clear understanding of which of these four tissue variables is contributing to someone’s shape.
The four tissue variables that determine what someone’s abdomen looks like are the following.
1) abdominal scan laxative, typically due to previous pregnancies or weight loss
2) excess subcutaneous fat
3) muscle separation from previous pregnancies
4) excess visceral or intra-abdominal fat
A tummy tuck primarily treats, abdominal skin, laxity, and muscle separation.
Liposuction will reduce subcutaneous fat
Excess visceral fat can only be lost through weight loss.
A sufficiently experienced plastic surgeon should be able to differentiate between these variables, predict outcomes accurately, and explain when someone is or isn’t a good candidate for any particular procedure.
The good news with that your procedure wasn’t done badly and quality results are still possible but you have to take ownership of your obesity, and do your part. There is no surgical treatment for excess visceral fat.
If you don’t have proper before, and after pictures to contact your previous provider and ask them to forward all the before and after pictures, they took. These are very important when it comes to making an assessment regarding your outcome. Before pictures talus your candidacy for the procedure, which determines if you have the potential for quality results or not. Generally speaking the two variables that determine quality cosmetic surgery outcomes are always patient candidacy, and provider skill. when results are lacking, the problem is almost always candidacy, Surgeon’s skill, or both.
Best,
Mats Hagstrom, MD