What can I do to correct the appearance of my stomach? 7 years post tummy tuck, bumpy and uneven (photos)

Question

I had a tummy tuck in 2016 and a pregnancy in 2017... I'm not sure if this is from lipo or from gaining weight with the pregnancy but how can I fix the overall look of my stomach? It seems bumpy and uneven... it's not hard like fibrosis... I'm not sure what my options are and if anything can help.

Randal Haworth, MD, FACS · Answer

Hello !

This is a difficult question to answer based on your photos alone. This could be related to your past surgeries. Pregnancy is likely to stretch out the muscle repair that may have been done during the abdominoplasty, but does not necessarily result in localized fatty irregularities as seen in your photos. Obviously, consulting with your original surgeon would be a good place to start otherwise, a board-certified plastic surgeon with experience in these issues. I hope this helps. Good luck

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding how to correct the appearance of your tummy seven years after a tummy tuck and subsequent pregnancy and weight gain. In regards to your abdomen, you have areas of irregularity. These should be corrected. I would suggest using liposuction for correction. Vaser liposuction can help to smooth irregularities, remove pockets of fat, and smooth out areas of scar tissue. I do not believe a revision tummy tuck is necessary. Please seek a plastic surgeon who specializes in revision liposuction. Thank you for your question regarding what to do with your tummy seven years after a tummy tuck, which left your abdomen uneven after pregnancies and weight gain.

Sincerely,
Dr. Katzen

Sincerely,
Dr. Katzen

John Mancoll, MD · Answer

Thank you for your question. The lumpy bumpy of your abdomen most likely is the result of internal scarring. It’s probably made a little bit worse in your case simply by the fact that you are so thin and you don’t have a whole lot of a fatty blanket to hide this irregularities. One of the things that can be done is to go back into surgery and simply do an equalization technique. With the help of a basket cannula that might allow for freeing up and stretching of the internal scar tissue and then hopefully it would be a smoother. Frequently, in cases like this, if I can also add some fat and a fat grafting technique once you freed up the space and scar tissue, then put the fat in to hopefully allow it to heal in a smoother way. I would tell most people that I could get about a 50% improvement from where you are right now with this technique. Another option might be to just go back and redo the tummy tuck. The downside of that would include a little longer recovery. The stiffness and lack of excess skin in the abdominal wall. At this point in your life, probably would not allow for a lot of skin removal, and as a result, the defect where the belly button is, will most likely have to be close is an up-and-down scar along the midline of your lower abdomen. It’s also very possible the tissues are stiff enough that it’s not gonna move much at all, in which case you could just do a float technique of the belly button, and then simply open it up to release the scar tissue, put a little bit tighter and then re-close. I would discuss all of these options with you if you are in my office considering surgery. Good luck on your body contouring journey.

Daniel Barrett, MD · Answer

Dear Concreteeuphoria,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

David Plank, MD · Answer

A board-certified plastic surgeon is qualified to address your issues. Board-certified plastic surgeons have spent years of training and have the top level of experience and skill. Seek out a board-certified plastic surgeon for your cosmetic needs

Connie Hiers, MD, FACS · Answer

You could have some very careful liposuction of the fuller areas and radiofrequency skin tightening like Renuvion or ThermiTight to help improve. Even treatments like micro-needling with radiofrequency can be helpful.

Mats Hagstrom, MD (license on probation) · Answer

The appearance of your abdomen is related to previously poorly done liposuction. Your previous provider does not have sufficient skill and experience to deliver quality liposuction results. Do you now have an uneven fat distribution that is going to be difficult to correct. Liposuction results are permanent an irreversible. It is extremely difficult to improve outcomes wants to procedure has been done if it wasn’t done well the first time.Some improvements may be possible, but secondary Liposuction will never give the potential outcome that quality primary Liposuction has the potential to do. Secondary or revision liposuction is many times more difficult than primary liposuction. Delivering consistent quality liposuction results is more difficult than most people believe. The number of plastic surgeons who can do liposuction well consistently on a regular basis is relatively small. Patients should be very selective when it comes to choosing providers for this procedure. Considering that revision work is many times more difficult than primary Liposuction you need to absolutely find the best provider. If you’re going to have any hope of improving your outcome. Attempt on secondary Liposuction Oreville Urgent Liposuction Canyon very easily make things worse than they are already. Recognize that revision work is technically very difficult and getting a perfect outcome is no longer possible. Some improvements can be had but this is highly dependent on finding the right provider. Set your expectations accordingly and begin the process of finding the most talented and experienced Liposuction expert in your community. Do that by having multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection and before and after pictures of abdominal liposuction results. It is unlikely you’ll find somebody to have significantly high numbers of results from revision Liposuction. The best surgeons to do revision liposuction are generally the same surgeons who do the best primary liposuction. 
An experienced provider should have no difficulty in showing you at least 50 sets of before and after pictures of commonly performed procedures, like tummy, tucks or abdominal liposuction. Being shown a handful of preselected images, representing the best results of a provider’s career is completely insufficient to get a clear understanding of what average results look like in the hands of each provider. Considering that you need revision work and how difficult this type of work is, do you need to be absolutely certain you’re in the hands of somebody who has mastered Liposuction. This means they should have performed thousands of Liposuction cases and have what looks like an endless collection of quality before and after pictures.
I usually recommend patience, five consultations before choosing a provider code for revision work you may need to schedule far more consultations than that to find someone sufficiently talented to give you the best shot of a normal appearing abdomen.
Being board-certified in plastic surgery with an overall good reputation and years of experience, does not mean that somebody is good at Liposuction.
Best,
Mats Hagstrom, MD

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