Mysterious Abdominal Distention After Abdominoplasty, What's Going On? (photo)

I had abdominoplasty/double hernia repair 16 months ago. Shortly after, I noticed severe abdominal distention. I look at least 6 months pregnant at all times. The gastro Dr. has ruled out everything under the sun and the plastic surgeon (who I no longer see due a failed breast aug he performed 3 weeks after my TT)has no clue. ALL Dr's agree there is a problem, but no one can seem to diagnose me. Has anyone seen this occur after a tummy tuck and last this long? I cannot live in this state!

Doctor Answers 5

Mysterious abdominal bulge (photo). How to treat?

The double hernia repair is the key, and indicates your abdominal wall is already subject to weakness.  Compound the hernia repairs with wide rectus abdominis plication accomplished during abdominoplasty, and the resulting tension exceeds intraperitoneal "eminent domain" and the pressure your abdominal wall deep connective tissue fascial layers are able to resist.  They relax to achieve a new equilibrium, which explains your distention.

Treatment is possible, and may or may not be successful.  Reoperation with elevation of the abdominoplasty flap, repeat plication, reinforcement with prosthetic mesh or acellular dermal matrix extending across the abdominal wall, and repeat skin removal to lower the scar as much as possible would be my choice.  Post surgical care involves wearing a latex free elastic binder snugly applied for three months (except when showering) to stablize the reconstruction.

San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Abdominal Distention after Abdominoplasty?

I'm sorry to hear about your experience after plastic surgery. This must be especially difficult given that you no longer have a good relationship with your plastic surgeon.

I would suggest that you seek consultation with 2 to 3 well experienced board-certified plastic surgeons;  your situation is too unusual/complex for online consultation.

At this stage,  the most likely explanation for the abdominal wall distention would be abdominal wall laxity secondary to relaxation of the muscle plication and/or recurrence of hernia.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Looking 6 months pregnant after a tummy tuck.

Thank you for the photo. This is highly unusual any time after a tummy tuck, especially 16 months out from surgery. You state that you had a double hernia repair at the time as well. Were these groin hernias or mid abdominal hernias? Was any mesh used to reinforce the weak fascia? Either your tissues gave way, you had an unsuccesful hernia repair or your surgeon committed some technical error. Need to see a board certified plastic surgeon for a second opinion and a thorough evaluation (possible CT scan of the abdominal wall) to determine the cause. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Abdominal wall laxity after tummy tuck

It is rare to see anything like this but if you had a "failed" breast augmentation also, maybe your plastic surgeon wasn't too technically good.  Obviously, needing a TT and having 2 hernias, you have poor tissue elasticity and this may well have contributed to the current problem, but if you see some outstanding plastic surgeons for an evaluation it might well be possible to redo the TT and retighten the abdominal wall with hopefully better results.  Sorry for your troubles.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Abdominal Distention a year and a half after a Tummy Tuck

I agree you look distended but without seeing you pre-surgical films it is hard to compare your present appearance to that before your Tummy Tuck. I think you need to be examined by either a General or a Plastic surgeon  to see if you have a hernia or if your original muscle repair done with the tummy tuck had become undone. This is not a common complication but it could explain your condition.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

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