Bulging Upper Abs After Mini Tummy Tuck

I had a Mini Tummy Tuck (and some lipo) done in my abs. It appears that the area below the belly button is tight but the upper abs area is loose and fills up quickly after a meal giving me that bulge.

In other words, pre-op, my belly would get fat on the lower half, now its fat on the upper half. I've had the surgery 2 months ago and I am a petite person. Do I have to go back for lipo in the upper abs or will time help me settle some fat back into the lower abs, making me look proportioned again?

Doctor Answers 13

Upper abdominal bulging after mini tummy tuck

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Liposuction will not likely solve your problem.

More likely is the fact that a mini tummy tuck only repairs the muscle below the belly button whereas the full tummy tuck repairs the muscle above and below the umbilicus.

The bulging you experience after a meal is due to the unrepaired muscles allowing the upper abdomen to distend whereas the lower abdomen remains restrained by the muscle repair.

It is possible that the lower abdominal repair may loosen and ease the difference. Alternatively, you may require tightening of the upper abodminal muscle separation. Liposuction will do little to relieve your symptoms.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Upper Abdominal Bulging after Mini Tummy Tuck

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Upper abdominal bulging is usually the result of inadequate plication (tightening) of the abdominal musculature during the mini tummy tuck.  In cases where the umbilicus (belly button) is not being repositioned, as when the focus of the procedure is the lower abdominal wall, it is difficult to reach the upper abdominal wall and sufficiently tighten the muscles.  In such cases, the muscles have been tightened below the umbilicus but not above it.  This, in effect, accentuates the upper fullness by juxtaposition of the untightened upper muscles with the tightened lower muscles.   When upper tightening is also necessary, a full abdominoplasty is often required, including elevation of the abdominal wall to the level of the rib cage and proper tightening of the muscles (plication) in the midline beginning at the xiphoid process (tip of the rib cage in the midline) to the mons pubis (pubic bone).

Bulging of the upper abs after a mini tummy tuck

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When performing a mini tummy tuck it is crucial to establish a good balance between the upper and lower abdomen. When examining a healthy young woman, it is common to see a flatter stomach in the upper abdomen than the lower abdomen. This must be kept in mind when performing a mini tummy tuck. If the lower abdomen is tightened excessively, this may create too much flattening in the area below the belly button and excess fullness about the belly button. Your best bet is to work with a board-certified plastic surgeon who will assess you and determine if you require suture plication to the area above your belly button.


Plication of the upper abdomen

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It seems that you will need a plication of your upper abdomen with or without Liposuction. this is a common problem when plication is not done in the same time for the upper stomach.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Full Abdominoplasty Vs. Mini Tummy Tuck

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When patients have redundant abdominal wall tissue following pregnancy, they will usually require a full abdominoplasty to correct the problem.  Although most patients would prefer a lesser procedure very few are good candidates for mini abdominoplasty.

Although you have recently had a mini abdominoplasty your current problems suggest that a full abdominoplasty may have been a better option for you.  The fact that your lower abdomen is tight and there is an upper abdominal bulge suggest that you have excess upper abdominal skin and weak upper abdominal muscles.

These problems would have been addressed with a full abdominoplasty.  This procedure would remove any excess skin and tighten the muscles of the upper abdomen.  Liposuction would most likely have no impact on your current problems.

It’s important that you discuss this issue with your plastic surgeon.  Correction of your problem will most likely require conversion of your mini abdominoplasty to a full abdominoplasty with umbilical transposition. 

Results from Mini Tummy Tuck

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Without examination, it is hard to say, but in my opinion, it sounds like you needed a full tummy tuck ( abdominoplasty) to acheive the results you were looking for.  Go back and discuss this with your surgeon, or get a second opinion.  Be sure to see a Board Certified Plastic Surgeon certified by the ASPS( American Society of Plastic Surgery) to resolve this issue.  Best of luck with that.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Upper abdominal bulge

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That effect is likely because only the lower half was tightened with surgery. Its important for the surgeon to create the balance and its unlikely that the upper portion  will "settle", although the lower abdomen will relax and create a better visual balance balance.

Mini tummy tuck problem

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Thank you for the question.

What you are describing is one of the problems they can be seen after the mini tummy tuck procedure is performed.

In my opinion, the mini tummy talk is an  operation that  produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.
For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck  surgery present for  revisionary surgery.
It is important to work with a well experienced board-certified plastic surgeon to obtain advice (based on good ethics and judgment) to  improve your chances of a successful outcome and minimize the need for further surgery.
I hope this helps.

Bulge after mini tummy tuck

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The upper abdominal bulge is most likely due to the weak muscles above the umbilicus that I assume were not plicated during the mini-tummy tuck. Repairing this will possibly get rid of your bulge.  An  exam would give me answers.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bulge following a tummy tuck

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Sorry to hear about your upper abdomen.  A few things are important here.  While you are not ecstatic about your upper abdomen, it is still early in the post-operative period.  It is prudent to wait at least 6 months before being critical of the outcome.  Nevertheless, it may be true that the muscle plication of your upper abdomen was lax.  That is, your fascia (layer enclosing the muscle) was tightened more below the navel than above.  However, most plastic surgeons either liposuction conservatively or not at all in the region beteen the ribs and the navel.  This is the area that supplies blood to the rest of your abdomen as it heals.  I would keep close follow up with your physician.  Voice your concerns, and give it some time.   Depending on the degree of bulging, further liposuction or possibly muscle plication may be required.

Jason Hess, MD
San Diego Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.