What happened to my tummy tuck? 5 years post-op (Photo)

Question

I had a tummy tuck 2017. August 17, 2021 I had anterior spinal lumbar fusion L4, L5, S1 through abdomen they moved intestines and nerves to get to spine. I noticed following surgery My abdomen was very inflamed like a pregnancy, 9 months after abdomen is still big but with a bulge more to the left where incision is. Ct scan last week says there’s Left lower quadrant abdominal wall laxity with relative protrusion of abdominal contents due to rectus abdominous muscle atrophy. What to do?

Alan Gonzalez, MD, FACS · Answer

Hello @disney123 thank you for your question and showing your pictures. A liposculture fixes the fat that you have at the skin level. However, if there is abdominal diastasis and excess skin the only way to improve is with a lipectomy with abdominal plicature. For more information and recommendations it is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Daniel Barrett, MD · Answer

Dear disney123,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Carmina Cardenas, MD · Answer

The protruding look is because of 3 reasons: Visceral fat gained after the Tummy Tuck, Loose muscle relapse as the result of the visceral fat re-gained, thick abdominal skin and the 3 combined would happen if you put on more than 5 lbs after surgery. 
So based on your photos my thinking is you put on significant weight after surgery, thinking you must've been at least 10 lbs lighter than the preop weight. 
I am pretty confident after you lose weight, your abdomen will improve significantly. If you don't lose weight your appearance will not improve not even with surgery. 
Be encouraged.
Dr. Cardenas

Connie Hiers, MD, FACS · Answer

You may have had some nerve damage when the disc had herniated or during the back surgery. I would suggest meeting with a board certified plastic surgeon and discuss tightening your abdominal muscles again.

Camille Cash, MD · Answer

It appears from your photo that the appearance of your abdomen is either related to visceral fat or weakened abdominal wall.  I encourage you to visit with a board certified plastic surgeon for an evaluation.  Bring along your CT scan results if available.  If the cause is visceral fat it can be addressed through weight loss.  If it is due to a weakened abdominal wall surgical correction would be necessary.

Cagil Meric Erenoglu, MD · Answer

It looks like the abdominal wall laxity should be corrected. What I would do is to set up an operation with a general surgeon (Plastic and General surgeon together) and after understanding what is going on inside with CT and Ultrasound, I would do abdominal wall strengthening with polypropylene mesh. 
Remember that loosing weight is extremely important for your condition, as internal fat tissue pushes the abdominal wall outwards and reduces its strength. So becoming slim will help the success of this operation a lot.

Mats Hagstrom, MD (license on probation) · Answer

It looks to me like you have excess visceral fat causing abdominal while bulging. It’s also possible that the spinal surgery weekend at the abdominal wall.
Excess visceral fat can only be lost through weight loss.
Take a look at your weight history and see if your weight is the same as when you had your procedure or when your abdomen looked its best.
Follow up with your plastic surgeon or consider a second opinion consultation with a new provider.
Best,
Mats Hagstrom MD

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your history, one of the paired anterior rectus muscles or its innervation appears to have been injured during the spinal fusion procedure. If it proves to be a nerve injury, regeneration of the nerve is possible over a period of 1-2 years. If no return of function is noted, you may be a candidate for reconstructive surgery.Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...

What happened to my tummy tuck? 5 years post-op (Photo)

Answers (8)

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