Stomach swelling won't go down, and skin feels too tight. What could this be? (Photos)

There are two primary reasons patients may experience upper abdominal bulging after a tummy tuck.
The first is patients who have excess visceral fat causing pressure against the abdominal wall. Muscle tightening is often more effective on the lower abdomen and the increased pressure has to cause a bulging somewhere and it typically shows on the upper abdomen more than on the lower abdomen where muscle tightening can be very effective. When visceral fat is the problem there’s usually a tight sensation and it takes force to press the abdomen flat. For this weight loss is the only treatment that will help.
The second reason for a bulging upper abdomen is patients who are barrel chested. If the chest is round rather than oblong with a sternum that sits significantly in front of the pubic bone abdominal wall will slant back after muscle tightening. The more aggressive the muscle tightening the worse the appearance of upper abdominal bulging. for patients will have this anatomic configuration surgeons can consider backing off on aggressive muscle tightening especially of the lower abdomen. it’s simply a body shape that is less than ideal for this procedure. A tight abdominal wall from surgical muscle tightening will create a beeline between the sternum core front of the rib cage and the pelvis. De more forward the rib cage and sternum sit the more the upper abdomen will bulge after the procedure. My best guess is that in your case you have both conditions and this explains why your results looks the way it does.
These types of results are predictable on individuals who are barrel chested and carry excess visceral fat before surgery.In a perfect world surgeons have sufficient insight, experience and knowledge to recognize which patients will get what type of results and will steer patients expectations accordingly.
Doing second opinion consultations based on a simplistic post on real self isn’t going to get you an accurate assessment.
To get a good assessment you’ll need a formal in person second opinion consultation. whenever doing second opinion consultations patients should come prepared with formal before and after pictures and a copy of your operative report for any previous procedure.
Best,
Mats Hagstrom MD