Still have a pooch after a tummy tuck. Any suggestions? (Photo)

Question

I had a tummy tuck last year and still have a pooch in my lower belly. I thought it may still be swelling after 6 months so I went back to see my surgeon and was told it was visceral fat. He also told me I had bloating and that going on a lactose free diet may help. He said if I lost 2-3 lbs and continue doing my sit ups, which I had been doing since 6 weeks post op, I would see a difference. I lost 11lbs, do my sit-ups daily and stopped lactose. It’s still there. Any suggestions??

Gerald Minniti, MD, FACS · Answer

Well, what it's not is intra-abdominal fat.  A lactose free diet would be worthless unless you are truly lactose intolerant, i.e. substantial gas and diarrhea within hours after eating dairy.  What it could be is persistent swelling (I give it one year for tummy tuck patients), persistent fat, both fat and swelling, or incomplete abdominal wall repair.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do with your tummy after a prior tummy tuck. From your history in your pictures, it appears that you have residual skin of your lower abdominal wall. If it were just this, it could be removed with liposuction. However, in the top picture I see excess residual skin. The only way to really remove skin from the anterior-abdominal wall is with surgical revision. I would suggest going through your prior tummy tuck scar and pulling the skin more tightly. In my opinion, this procedure can probably be done under local anesthesia in the office. Please consult with your plastic surgeon. Although it’s always a good idea to watch what you eat, diet and exercise, I would suggest more of a ketogenic diet to further reduce your weight. However, further weight loss I believe will make this problem worse not better because this is a skin problem not a visceral fat or fat under the skin problem. I hope this answer helps.

If you have any more questions regarding a tummy tuck, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 tummy tuck or circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, tummy tuck or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Camille Cash, MD · Answer

It's difficult to tell what is causing the contour that concerns you without an exam.  If it is subcutaneous fat it could be addressed by liposuction.  Some other potential causes are swelling persisting from surgery, visceral fat, or failure of the muscle wall repair.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Most likely this is a bit of skin and fat discrepancy between the upper abdominal skin and the lower pelvis.  If this does not improve with time, light liposuction may be able to improve upon your results.

Daniel Barrett, MD · Answer

Dear lizzy9407,
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

Still have a pooch after a tummy tuck. Any suggestions? (Photo)

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Answer: Still have a pooch after a tummy tuck. Any suggestions? (Photo)

Answer: Still have a pooch after a tummy tuck. Any suggestions? (Photo)

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Still have a pooch after a tummy tuck. Any suggestions? (Photo)

Answers (9)

Answer: Still have a pooch after a tummy tuck. Any suggestions? (Photo)

Answer: Still have a pooch after a tummy tuck. Any suggestions? (Photo)

Answer: Tummy tuck results

Answer: Tummy tuck results

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Everything you need to know about Tummy Tuck

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