Advice for revision TT? Still have hernia, epigastric bulge & inadequate tissue removal (Photos)

To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took. Without knowing what you look like before the procedure, we can’t make an assessment on the outcome of the surgery. Understanding the procedure in the first place is key to understanding why the results look the way they do. From the pictures you’ve shown your result is fairly typical. Bulging of the upper abdomen typically happens for two reasons.
Individuals who are barrel chested can’t I have Tommy top results with fullness in the upper abdomen compared to the lower abdomen. Another way to make this assessment is to compare the relationship between the sternum and the pubic bone. If the sternum sits significantly forward to the pubic bone then muscle tightening creates a backwards and slanted abdominal wall with more projection of the upper abdomen than the lower abdomen. Generally speaking the more aggressive, the muscle tightening is done the more of this in inverse abdominal wall angle is created. The second reason patients have bulging of the upper abdomen is in individuals who have excess visceral fat. This can often be determined preoperatively during consultations. Individuals who have excess visceral fat need to lose weight or they will have bulging despite muscle tightening. This often shows more in the upper abdomen than the lower abdomen. Visceral, fat, and body contour relationships can contribute to results, which are generally fairly predictable based on accurate assessments during in person, preoperative consultations.
Tummy tech is a fairly permanent and irreversible procedure. The amount of improvements possible with revision surgery may be limited and choosing to redo the entire procedure should be addressed with a certain degree of conservativeness.
Best,
Mats Hagstrom, MD