Why does my stomach bulge out still and hang? Do I need a FDL or what is needed to be flat? (Photo)

Dear Eclectic150940,

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

Hello
While you have significant excess skin both horizontally and vertically, the excess skin was only removed in the horizontal plane. Therefore, there is still a buildup of vertical excess skin along the midline. From the beginning, FDL should have been performed. It still needs to be added.

It would be possible to remove more skin and fat and retighten the abdominal muscles. Liposuction of the abdomen and waist would be important as there is more limited amount of skin which can be removed in a revision.

Abdominoplasties after extensive weight loss are notorious for problem like yours; extended skin excision, poor elasticity, stretched and weak abdominal wall, are contributing to residual deformity like yours. Further excision of vertical skin folds and additional horizontal skin excision are needed for better result. You should discuss these issues with your surgeon or request a second opinion consultation. Good luck.

Your issue is twofold. First, an insufficient about of skin and fat was removed in your prior surgery. You would benefit from circumferential liposuction and re-advancement of the skin to at least as far as your scar. Second, you will also need a vertical excision of skin due to circumferential skin excess that cannot be removed by your extended tuck. This means a vertical scar that traverses your abdomen, creating a scar pattern known as a 'fleur de lys'. This combination of procedures, performed in a single surgery, will leave you thinner and tight.

Adding the FDL approach will help tighten the mid abdominal tissue that could not be tightened with just the lower incision. go back and discuss this with your surgeon. Part of the lower incision will also need to be included with this procedure.

From the submitted photos it appears you will have improvement if you considered a revision. A fleur de lis would better address the excess skin along the middle abdomen. Further excision of the excess skin at the hip level can be performed at the same time. See a board certified plastic surgeon near you to learn more.

Appears you do need a FDL revision tummy tuck expect fees to range from $15,000-$25,000. Best of virtual consult with.