Tummy not flat six months after tummy tuck with muscle repair (no lipo) (Photo)

Question

Hello, I am 40 years old, 103 lb, 5'3" with 2 kids. Waist 25" before I had kids. Post tummy tuck it is 29". My weight is the same as pre kids. My surgeon and physical therapist say the muscle repair was successful. My abs are together. Surgeon sent me for a CT to check for ovarian cysts. Results normal. What might be causing my distended abdomen? Is it reasonable to expect a better result? Thank you.

J. Timothy Katzen, MD, FACS · Answer

Dear Lindsayb920,

Thank you for reaching out with your concerns regarding the persistent protrusion in your abdomen six months post tummy tuck with muscle repair. I appreciate the detailed history and the postoperative photos you've provided.

While it's challenging to gauge the exact change in your rectus abdominis muscle without pre-operative pictures, I would trust your plastic surgeon and physical therapist's assessment that your muscles were indeed repaired. If they were properly repaired, then any distension is likely due to the contents of the peritoneal cavity pressing against the muscle wall.

Given that you are 103 pounds, suggesting further weight loss doesn't seem like the ideal solution. An alternative approach to consider is the insertion of surgical mesh. Here's a brief overview:

The procedure begins with an incision made along your prior tummy tuck line.
The entire abdominal wall is then undermined and exposed.
A sizable piece of surgical mesh (approximately 8" x 10") is placed over the central abdomen.
This mesh is then securely attached to the rectus fascia and tightened.
The objective of this procedure is to provide added reinforcement and constriction to the anterior abdominal wall. It's admittedly an aggressive approach, but it has shown efficacy in flattening the abdomen, even post a muscle-repaired tummy tuck.

I hope this information offers some clarity and insight into potential solutions for your concerns. I wish you all the best in your journey toward achieving the results you desire.

Sincerely,
Dr. Katzen

Leila Kasrai, MD, FRCSC · Answer

If there is no subcutaneous fat and the muscle repair was successful, then there is a good chance that the issue may be related to either bloating or visceral fat.

Karl William Schwarz, MD · Answer

If you are not flat after a tummy tuck then it is either weakness of your stomach muscles and despite being re-approximated and in good position they are still weak so plank exercises over a year will help to flatten your abdomen. The other reason for not having flat tummy after a tummy tuck is internal fat otherwise known as visceral fat can cause bulging in the upper or lower abdomen and despite being very thin can still benefit from weight loss.

It is very frustrating for patients and surgeons when patients are not flat after having a tummy tuck. Aside from performing liposuction, removing skin and tightening the abdominal wall and repairing rectus diastases there is nothing more that can be done during a tummy tuck to get patients flatter stomach. In fact, most patients get a good result with a tummy tuck but those who do not will benefit from either a small amount of weight loss or strengthening of the abdominal wall.

Camille Cash, MD · Answer

If the muscle repair is intact then the issue is possibly behind the muscle wall.  I encourage you to visit with a GI specialist to explore potential causes of the abdominal contour.  Your surgeon is your best source to guide you towards causes as she/he is most familiar with the details of your surgery and how you've been progressing through recovery.

Scott C. Lindsay, DO · Answer

Thanks for your question! If the muscle repair is still in tact, it's not unreasonable that something in your diet could be causing bloating and distension. I would suggest seeking another opinion with a gastroenterologist. Good luck!

Tummy not flat six months after tummy tuck with muscle repair (no lipo) (Photo)

Answers (9)

Answer: Six months post op

Answer: Six months post op

Answer: Dietary

Answer: Dietary

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Everything you need to know about Tummy Tuck

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Tummy not flat six months after tummy tuck with muscle repair (no lipo) (Photo)

Answers (9)

Answer: Six months post op

Answer: Six months post op

Answer: Dietary

Answer: Dietary

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.