3 years post op - lower belly protruding & very hard constantly (Photos)

Question

I workout 4-5x a week. I have very minimal body fat. I went and got ultrasounds to rule out any women problems with the uterus. My lower belly has been hard and firm since surgery but it seems to be growing or appearing larger. What would cause this? When I lean forward you can see a mass almost and I can feel it. It’s very uncomfortable.

Daniel Barrett, MD · Answer

Dear Considerate88127,
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

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for providing your photos and history. Based on your photos, it appears that your primary concern is a firm, protruding lower abdomen three years after your tummy tuck. Since you have minimal body fat and no excess skin, the issue is likely related to muscle weakness or an incomplete rectus abdominis plication during your initial surgery.

When performing a tummy tuck, many surgeons repair the rectus abdominis muscles, which may become separated due to pregnancy, weight changes, or other factors. This repair is typically done with permanent sutures to tighten the abdominal wall. If this was not performed, or if the repair has since weakened or separated, it could result in a firm, distended lower abdomen as the muscle cannot adequately hold the abdominal contents in place.

To address this issue, revision surgery may be necessary. A plastic surgeon would make an incision along your previous tummy tuck scar, elevate the skin and tissue, and repair the rectus muscles from the sternum to the pubic symphysis using permanent sutures. In some cases, mesh may be added to reinforce the repair, providing additional support to the abdominal wall.

I recommend consulting with a board-certified plastic surgeon who has extensive experience in revision procedures. Be sure to discuss whether rectus muscle plication was initially performed and how a revision could improve your results. This type of procedure can significantly flatten and strengthen your abdominal area, resolving the firmness and discomfort you are experiencing.

Sincerely,
Dr. J. Timothy Katzen, MD, FASMBS, FICS

Leila Kasrai, MD, FRCSC · Answer

Please see your surgeon for an assessment. It could be caused by a variety of reasons, and an in-person exam would be necessary. Surgery may be required to resolve the issue.

Camille Cash, MD · Answer

I encourage you to return to your surgeon for an evaluation.  The reason for the contour of your abdomen could be related to many things.  There may be a seroma present, the muscle repair may have failed, to name just a couple.  Your surgeon can assist you in finding out what is occurring.

Ajaya Kashyap, MD · Answer

Thank you for your query. There may be a loosening of the muscle repair in the lower part of the abdomen or some visceral fat . This can be confirmed with an MRI. Please discuss your concerns with your Plastic surgeon who can examine you and help you with your concerns. All the best!

3 years post op - lower belly protruding & very hard constantly (Photos)

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3 years post op - lower belly protruding & very hard constantly (Photos)

Answers (10)

Answer: 3 years post op

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Answer: Lower belly protrusion after tummy tuck

Answer: Lower belly protrusion after tummy tuck

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Everything you need to know about Tummy Tuck

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