9 months post tummy tuck. What can be causing roundness in lower abdomen and which procedure can help minimize this?

It would be hard to tell you exactly what to do without in person evaluation. Excersise of abdominal muscles should tighten your abdomen (not sutures); possibly small liposuction in the areas of prominence and laterally may further improve your shape. Hope this helps.

Althought it is difficult to say what was exactly done in your surgery, it does appear that you may benefit with further muscle plication. If you have a rounded lower abdomen (protrusion) and it goes away with sucking in your tummy, then that would indicate to me that you still have some laxity in the abdominal wall. This laxity would be addressed by tightening i.e. plication.

Hope that helps.

Dear mango88,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

You can do EMSculpt to tighten your abdominal wall and remove excess fat both outside and inside your muscles.

From your photos and description it is likely the contour that is bothersome could be solved with muscle plication. This would obviously require a revision. It's doubtful that liposuction would improve it. I encourage you to speak with your surgeon about your concerns.

I feel the lack of muscle plication is the reason your lower abdomen is 'pouty'. You appear to be quite flat and thin, so I doubt that further work outs will resolve this issue.
Revision abdominoplasty with plication of the lower abdomen would solve this issue.
Best wishes
Dr. Taranow

Based on the nicely posted photos you need reopening the complete TT with muscle plication -Sorry. Best to virtual consult with… fees from $8,000

Operations should be decided upon based on having a clear understanding of what the problem is. In other words the first step is to make an accurate assessment with a clear understanding of the problem or diagnosis.
For the front of the abdomen there are four variables that determine what it looks like.
In other words if someone doesn’t like derived amend it is always because of one or more of four different variables.
There are exceptions but generally aesthetic abdominal issues are related to either skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies or excess visceral fat.
Obviously baseline musculoskeletal structure has an impact but when the issue is more related to changes in the abdomen overtime then generally the four variables need to be put in the forefront and the primary, secondary and tertiary needs to be deciphered.
In regards to treatment abdominal skin laxity is best treated with a tummy tuck, if the skin laxity is only pertinent on the lower abdomen then it’s possible a mini tummy tuck can be sufficient especially if there’s no issues with muscle separation.
Excess subcutaneous fat is best treated with Liposuction or weight loss.
Muscle separation can only be treated with a full tummy tuck.
Excess visceral fat can only be treated with weight loss.
Generally speaking women who have had previous term pregnancies should have muscle tightening as part of a full tummy tuck because all women develop some muscle separation even if it isn’t a significant amount. while muscle tightening increases pain during early recovery it generally makes for a much tighter flatter abdomen and can potentially bring in the waist towards the midline.
Issues related to the contour of your abdomen after the procedure can be broken down into issues related to skin laxity, subcutaneous fat or the shape and contour of the muscle wall or possibly bulging from visceral fat.
It’s not that different than how we assess the abdomen before the procedure.
Based on what you describe a partial muscle tightening or only putting in stitches in part of the abdomen is not typical and will put the patient at a significant risk of having an abdominal wall that does not create a beeline between the sternum and pubic bone.
If the problem is related to insufficient or incorrectly done muscle tightening then revision with correct muscle tightening would be the correct treatment option.
A good plastic surgeon will be able to differentiate which tissue layer is causing problems and apply a correct procedure than addresses that tissue layer. Sometimes it’s more than one tissue layer and sometimes it’s not. When there’s more than one tissue layer involved they’ll be a primary, secondary potentially tertiary issue and the importance of treating those depends on how much they are contributing.
Follow up with your provider and talk to him or her about doing a revision. Alternatively you can schedule a few in person second opinion consultations with other board-certified plastic surgeons in your community. For a quality a second opinion consultation you should come prepared bringing with you all proper before and after pictures taken by your previous provider as well as a copy of your operative report. these are all available from your surgeons office as they are part of your medical record which you have a right to.
Best,
Mats Hagstrom MD