Had standard TT; upper abdomen sticks out? (Photos)

I had a standard No Drain TT July 29; had over 3 months to heal. I feel that my upper abdomen looks and feels the same as before the TT. My lower abdomen flattened out nicely and scar looks great, but upper abdomen isn’t matching. I was told it’s still swollen. Also you can see that my left side is puffier than the right. I’m just trying to get an opinion on it because it looks like nothing happened to the upper abdomen. What do you think about the upper abdomen and sides? Thank you so much.

Doctor Answers 7

Had standard tummy tuck; upper abdomen sticks out?

Thank you for the question.

As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.

An abdominal wall "bulge" after tummy tuck may be related to:

1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.

2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary. 

3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.

4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.

Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  for complete skin redraping  to occur.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Upper abdominal fullness is common

following tummy tucks and tightening of the muscles as the muscles pull the overlying skin medial as the muscles are tightened.  My patients all expect this and know that liposuction should help it flatten adequately down the road.  Swelling may be a small component but believe me, its probably excess tissue at this point.  You can be patient and wait a few more months and if it doesn't change, you have excess fat and your surgeon can make it better with office liposuction.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

After tummy tuck

Hi and thanks for sharing your photos. My question would be, did he do muscle repair? If he did this could be swelling or fat (intra abdominal or under the skin). Wait at least 6 months to see final result. Some surgeons prefer not to do liposuction in this area at the same time with the tummy tuck to avoid wound opening or necrosis but after a few months you can get liposuction done. Losing some wight will help.

Best wishes

Hector Milla, MD
Mexico Plastic Surgeon
4.5 out of 5 stars 34 reviews

Upper abdominal protuberance

You are demonstrating a muffin top deformity following TT. This can be caused by poor muscle tension whereby the tightening of the lower abdomen is performed more aggressively than the lower abdomen. Please see link below for more info.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews

Had standard TT; upper abdomen sticks out?

There could be several reasons why the upper part of your tummy protrudes.

1.  Healing is not complete.  Tummy tucks take minimum 6 months to heal and usually up to one year.  You may still have some residual swelling of the tissues beneath the skin including fat and maybe where the muscles were repaired.

2.  Persistent excess fat under the skin in the upper tummy area.  Some surgeons liposuction the fat beneath the skin of the upper tummy and some do not.  Just the preference of the surgeon.  If not done at the time of the tummy tuck, it can be performed at a later date.  Usually done when healing is complete.

3.  Excess fat inside your belly (intestinal fat).  This is the fat under the muscles called visceral fat that cannot be removed with a tummy tuck or liposuction.  We all have it.  Some more than others.  It will cause the belly to protrude even after a well-performed tummy tuck.  It can only be lessened with diet and exercise.  And of those two, diet is much more important.  A low-carb diet with avoidance of sugar, flour products and processed foods is successful.

Best plan for you is to discuss this with your surgeon, give yourself more time to heal and try to lose that visceral fat.  You will be much happier with the result in the long run.

Dr Spies

Robert J. Spies, MD
Paradise Valley Plastic Surgeon
5.0 out of 5 stars 89 reviews

Had standard TT; upper abdomen sticks out? (Photos)

This may have to do with the tightening of the upper abdominal muscles. Please follow up with your doctor as these issues require the attention of a plastic surgeon.

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 294 reviews

Upper abdomen swollen.

Thank your so much for bringing up your concerns. At 3 months after surgery, you certainly could be swollen and with time the upper abdomen may get better. I suggest you follow up with your plastic surgeon after 1 year from surgery in case the area does not improve. Occasionally, seroma or continuing muscle weakness can lead to a fuller upper abdomen. You should also consider sticking to a good diet and exercise program to make the most of reshaping your body. Congratulations and good luck, 


Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 202 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.