Why is my stomach bulging after tummy tuck & muscle repair? (Photos)

Thank you for your question regarding why your tummy is bulging after a tummy tuck and muscle repair. The tummy tuck procedure usually includes muscle plication and elimination of excess skin and fat of the abdomen. Swelling after the surgery can take up to 12 to 16 weeks to subside. If liposuction as well is involved, the recovery may be longer. In your case, I would definitely suggest that you continue wearing your garment and be very conscientious of what you eat, and continue to exercise. It is important that you express your concerns to your plastic surgeon. However, to me, your swollen abdomen looks like normal routine postoperative swelling. Good luck. I hope this helps answer your question regarding why your stomach is bulging after a tummy tuck.

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.)

Hello @Optimistic49441 thank you for your question and showing your pictures. I understand your concern. It is important to take into account several aspects among which is the surgical technique applied, and to evaluate if there is something else at a systemic level to make your stomach bulged. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

Thank you for sharing your question and series of photographs and I am sorry that your results have not been what you anticipated.  It is difficult without an in-person examination to determine what may be taking place. In most cases this is persistent swelling which will resolve spontaneously given sufficient time.  It is important, however, to ensure that other issues are not taking place - discrete fluid collection, muscle laxity, or residual adipose tissue.  Since your surgeon knows the full details of your operation, they are in the best position to provide you with a diagnosis and treatment option. Best wishes.  

Dear Optimistic49441,
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

Hello and thank you for your question. I agree with others that there are multiple possible explanations. I will say the most common reason for bulging postoperatively is visceral fat, or fat around the organs that can only be changed by weight loss, not by surgery. The other possible answers are that the muscle repair was not completed above the belly button or postoperative swelling. In some cases skin loosens up after being pulled so tightly during surgery, however it is difficult to ascertain based on photos alone. I do recommend seeking advice from your surgeon. Best of luck.

Hello. Thanks for posting your query. There are multiple factors that can cause bulge. Most common cause is due to internal or visceral fat which can only be reduced with regular exercise and weight loss.I recommend you to visit your surgeon and get advice from him. Hope I have cleared your doubt. Best wishes!

In liposuction or tummy tuck we can not take the fat that is under the muscles. We can only repair the rectus muscle to get a thinner abdominal circumference. If you gained weight after operation, probably you got all that fat into your internal reservoirs so it is now pushing your stomach forward. I recommend to loose weight to reduce the tension on your muscles.

It's difficult to say what is occurring without more information. Depending on when you had surgery you still may be experiencing swelling. Another potential issue is that your diastasis repair has failed. You may also be seeing the effects from visceral fat, or the fat that's located behind the muscle wall around the organs. This fat cannot be addressed during a tummy tuck. I encourage you to visit with your plastic surgeon to discuss your concerns.

When making the assessment on the front of the abdomen plastic surgeons look at four variables.

In other words if someone doesn’t like the way their belly looks it is always because of one or more of four variables. each of these variables is treated differently and to get a quality result requires addressing each one both in regards to assessment and treatment if indicated.

The four variables are skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat.

Your preoperative pictures show skin laxity with muscle separation and visceral fat as being the primary problem. Your pictures do not show you having much subcutaneous fat.

Sometimes muscle separation and visceral fat can present in a similar fashion.

To differentiate between pregnancy related muscle separation called deus stasis recti and excess visceral fat one can see how much pressure it takes to push the abdomen flat or see if it lays flat while laying on your back. This only works as an assessment tool prior to having a tummy tuck.

If someone bulges after a tummy tuck especially bulging in the upper abdomen it is usually because of one or more of the three reasons.

The first and most common is a patient who has excess visceral fat and this was typically visible on the before pictures and should’ve been discussed during the consultation.

The second reason someone may bulch and they’re operabab men or have an upper abdomen that sticks out more than the lower abdomen is because their chest is barrel shaped compared to their pelvis.

This typically presents with someone who is sternum sits significantly more forward compared to their pubic bone.

When patients are barrel chested or have a sternum that projects more than their pubic bone muscle tightening becomes more effective on the lower abdomen creating the appearance of the upper abdomen bulging.

The third reason someone may bulge after a full tummy tuck is insufficient muscle tightening.

Your preop pictures show a bulging abdominal wall which most likely is due to excess visceral fat and this is probably the primary reason you’re now bulging.

Initially aggressive muscle tightening holds people flat without the increased intra-abdominal pressure may create a sensation that is difficult to take a deep breath and the abdomen may feel firm or it’s difficult to press it in any further.

With time to tissues stretch and the upper abdomen typically bulllges because it’s easier to give secure muscle tightening to the lower abdomen.

Typically weight loss will correct the problem and reduce the visceral fat.


An examination is typically needed to differentiate and make a quality assessment and further recommendations.

It’s also important to look back over history and see if your weights been consistent before surgery immediately after and currently.

Consider checking your weight and losing five or 10 pounds and take pictures for comparison.

My best guess is you’ll see a significant improvement with weight loss.

Alternatively follow up with your provider.

Best,

Mats Hagstrom MD

Hello and thanks for your question. There are different factors that may affect the result of the tummy tuck. These factors are; Gaining weight, Seroma(Collections of wound fluid) and stitches opening of the muscle repairing. To understand what is the reason of it, You should have the in-person consultation with the plastic surgeon.