Six months post tummy tuck with bulge in upper abdomen (Photos)

Question

Six months ago i had a tummy tuck with muscle repair and liposuction to upper and lower abdomen. I am 5'7" and weigh 145 lbs. I have always been very slim but having three babies really stretched out my tummy, leaving me with a severe diastasis. My stomach is rounded and not flat at all. In fact, i have a slight bulge above my belly button. I have seen my Plastic surgeon about it and he is suggesting a revision (which i do not want to do). Why isnt my stomach flat?

Daniel Barrett, MD · Answer

Dear nomadd,
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

Darryl J. Blinski, MD · Answer

Based upon the posted photos your results are terrific! Why even consider doing anything? So you have a minor bulge as compared to your pre op photo all I can say is WOW!

Camille Cash, MD · Answer

It is difficult to determine what may be occurring without an examination.  From your photos it appeared you had a severe diastasis prior to your tummy tuck.  It may be that a portion of the repair failed.  A revision would be needed in order to correct this.

Mats Hagstrom, MD (license on probation) · Answer

There are three primary reasons patients can have bulging especially of the upper abdomen after a full tummy tuck.

The first and most common reason is obesity with excess visceral fat pushing against the abdominal wall.

The second most common reason it’s related to the relationship between the thorax and pelvis.

People who are barrel chested or have a sternum that sits significantly in front of the pubic bone tend to have an upper abdomen that bulges somewhat compared to their lower abdomen.  this can be addressed to some degree by not tightening the lower abdomen to its maximum during the procedure but the abdominal contour varies a bit based on underlying anatomy.

The third cause is insufficient muscle tightening.

Without having been present at your surgery it’s hard to know but considering that your  diastasis rectii was far beyond what we normally see a partial result should probably be considered quite successful.

If you’re unhappy with your current outcome consider looking at your before pictures a little longer.

The alternative is to redo the procedure.

It’s easy to play Monday morning quarterback. Perhaps your result would’ve been improved if you had plastic mesh sewn onto your abdominal wall. There are good reasons to avoid the use of mesh and sometimes it’s use is helpful.

To get a proper second opinion I suggest having in person second opinion consultations. For a second opinion consultations patients should come prepared with proper before and after pictures and a copy of your operative report which are all available from your surgeons office if you request them.
Second opinion consultations should ideally be done in person.

Best,

Mats Hagstrom MD

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your photos, I note that your preoperative appearance demonstrates marked abdominal wall laxity with moderate stretch marks extending above the belly button. The initial postoperative photo was taken with you bending forward. The later postoperative photos demonstrate marked improvement in appearance with minimal residual abdominal fullness.Stretch marks indicate the presence of permanently damaged overstretched skin usually occurring during pregnancy or significant weight fluctuation where when pregnant or obese, the skin's dermal elastic fibers rupture, resulting in the loss of elasticity and the development of streaks on the skin surface. The skin will stretch over a greater surface area and will predispose to further sagging. When bending forward, the distance from breastbone to pubis is shortened, but the inelastic skin does not contract. The nature of the your post-surgical fullness may be due to lax skin, lax rectus muscle repair, or the presence of visceral fat (doubted as your BMI is only 22.71). An in-person evaluation is required.You will never achieve your pre-pregnancy appearance. But 15% of cosmetic surgeries can be further improved with secondary revision.Best wishes...

Six months post tummy tuck with bulge in upper abdomen (Photos)

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