Still have lower belly pooch - Is a tummy tuck revision needed? (photos)

Question

I am 10 months post op. I am 5’5, approximately 168 pounds. I was 171 the day of surgery. I am working out but have definitely hit that age where it’s not as easy to lose weight. I was 43 at the time of the procedure. I am wondering if I need a revision. I still have a lower belly pooch and the left side of my abdomen is larger than the right. I discussed the size difference with my surgeon when I first noticed it but he said that it was nothing. It’s not aesthetically pleasing.

Carmina Cardenas, MD · Answer

The main problem of your abdomen, because of your genetics,  is that after surgery you hpave gained a lot of visceral fat and having in mind our muscle and fascia is literally a steak, the muscle repair will not prevent the protruding appearance because the muscle overstretched again. 
It will be extremely important you lose the weight probably about 10-15 lbs in order to lose the visceral fat and automatically you will become flatter and your waist line will reappear. And after the weight loss, you may improve your results with some liposuction to abdomen and waist. 
Be encouraged. 
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear nursekaybell,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

Connie Hiers, MD, FACS · Answer

You have a nice results, but still have internal fat that cannot be treated with a tummy tuck, but with weight loss.

Camille Cash, MD · Answer

An in person evaluation is always best, but from the photos it appears the culprit for your abdominal contour is visceral fat.  This is fat around the organs that cannot be improved with a tummy tuck or liposuction.  Weight loss, though challenging, is the way to improve your concern.

Darryl J. Blinski, MD · Answer

Based upon the posted photos, which really help. I would revise the complete TT incision with anterior liposuction. Fee $6,500 ranges. Virtual consult with me.

Mats Hagstrom, MD (license on probation) · Answer

Your abdomen still bulges because you have excess visceral fat.

The best way to improve the results of your tummy tuck is with weight loss.

In a perfect world your provider would’ve discussed the visceral fat with you before surgery during the consultation as a potential issue or mentioning that weight loss was needed to get the best results.

No one said weight loss was easy but it shouldn’t require suffering either.

I don’t think you need more surgery. You need to reduce or change what you’re eating and consider changing your exercise routine.

Obesity has more to do with eating habits than it does with exercise.

Best,

Mats Hagstrom MD

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