Tummy tuck with muscle repair 13 months ago. There is more excess skin than before. Was I botched? (Photo)

It does appear that you need a repeat tummy tuck, as you still have excess hanging skin. You should discuss this with your surgeon.

Best Wishes,

Gary Horndeski, M.D.

Dear Sandyd2226,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your query. Based on your photographs, you will benefit from some further tightening of your skin especially vertically ( you already have a scar there). An ultrasound can also clarify if you have persistent seromas . If you are not happy with your Plastic surgeon please get a second opinion from a board certified Plastic surgeon who can examine you and help you with all your concerns. All the best.

Your implants are too large and heavy for your frame. You will need to go down in size and maybe need mesh to repair. Your photos show no "excess fat all over" your body. Please visit with your surgeon about your concerns. You will have some excess skin on your abdomen when you bend.

Hi are pictures 3, 4 and 5 preop?
If they are all post op pictures it does appear that you have extra skin and abdominal wall laxityYou may need a fleur de lis abdominoplasty to best contour your abdomen if this is the case.
The second standing picture however seem to show a great result.

If you are not satisfied after speaking to your surgeon about your concerns it's best to visit with another board certified plastic surgeon near you for a second opinion. There will always be some skin laxity when bending or in a seated position, but an exam will reveal if there will be enough for further removal. It will be helpful if you can bring your preop photos as well.

To make a quality assessment regarding the outcome of a plastic surgery procedure We generally need to see proper before and after pictures. If you don’t have a complete set of before and after pictures and ask your surgeon to forward the pictures they took.
Individuals who develop abdominal skin laxity typically have laxity in the both a horizontal and vertical direction. A tummy tuck only treats, vertical skin laxity. To treat horizontal skin laxity requires a fleur-de-lis pattern incision which leaves and undesirable scar for most patients who only have moderate skin laxity. All individuals will have skin laxity in a sitting position. This is true whether you’ve had surgery or not..
The result looks like a fairly typical or even above average tummy tuck result. The incision was placed appropriately low and is well designed. The belly button looks natural. There’s no evidence that the procedure was not done well.
There are always inherent limitations to what surgery can, or cannot deliver. Understanding your candidacy for the procedure and understanding what surgery can, or cannot accomplish is paramount in delivering high patient satisfaction.
It’s reasonable for providers to charge for second procedures if the procedure was done well in the first place.
I suggest having a few in person second opinion, consultations to get a better assessment regarding the outcome of your procedures. For a second opinion, consultations patient should come prepared bringing with them a complete set of before and after pictures and a copy of your operative report. These are all available from your current provider’s office if you request them.
Best,
Mats Hagstrom, MD

Evaluating a 2D print image of a body can be tricky, what I can recommend you is to go to your doctor and explain your concerns, he is the surgeon that performed your surgery and knows the goals he has accomplish with you. If you still have doubts about your surgery, remember that you can seek for seconds opinions, use always a board certified plastic surgeon. Nothing replaces a good in person evaluation.