Is It Safe to Have a Second Full Tummy Tuck?

Question

I had a full tummy tuck 8 months ago. I still look like I am 4 months pregnant. I have to suck in my stomach. My PS tells me I will need to redo my full surgery again. He is not sure why I am not as flat as I should be. He thinks it may be my muscle. I have muscle repair done the first time also. I will not be charged full price.

	How safe is it to redo the surgery? Is it too early? Is the pain and recovery time the same as the first?

Richard J. Bruneteau, MD · Answer

A persistent bulge following abdominoplasty can occur for a variety of reasons. When this situation arises a careful analysis of the problem is necessary before proceeding with revisional surgery. Possible explanations include inadequate resection of excess skin, inadequate tightening of the muscles, persistent laxity of the muscles, residual subcutaneous fat and separation of the muscle repair. Depending on the cause of the post-surgical abdominal bulge, revisional abdominoplasty may be indicated. Under these circumstances the muscles can be tightened and excess skin removed. In some cases, weight loss may be more appropriate, while in other cases ancillary procedures such as liposuction may be indicated.It's virtually impossible to know what option is best for you without pictures and a physical examination. It's important to get an opinion from a board-certified plastic surgeon before proceeding with intervention. Revisional surgery shouldn't be undertaken for at least six months following the original procedure.

Elizabeth Slass Lee, MD · Answer

Having to redo a tummy tuck is an unusual circumstance, but if you are healthy, it should be a safe procedure. It is impossible to know from an internet posting why you did not get the result you were hoping for, and I am glad that your surgeon is speaking to you about this and is willing to help you for a reduced fee. In the same way that it is sometimes valuable to see more than one surgeon in consultation, it probably makes sense now to get a second opinion from another board certified plastic surgeon about the best way to redo the tummy tuck. Information is very important when trying to decide the best way to proceed in this situation.

Armando Soto, MD, FACS · Answer

Hi there-
Without knowing more, it is hard for me to understand why you may not have gotten the outcome you desired.
Having said that, it is safe to re-do your operation (just extremely rare). Be sure you carefully follow your surgeons every instruction.

Brent Moelleken, MD · Answer

The single biggest cause of a persistent bulge after a tummy tuck done by a competent plastic surgeon is fat inside the abdomen.  This cannot be fixed by more tummy tucks, but must be cured with weight loss.
Intraabdominal fat is the worst with respect to diabetes and heart disease, so it is worth pursuing.

David Shafer, MD, FACS · Answer

It is unusual to have to have a second tummy tuck. However, we do not know all the circumstances of your situation or have before and after pictures. Sometimes the rectus plication (tightening of the muscles) looses and needs to be replaced - however, again, this would be very unusual. In this instance, the recovery is much less than the original surgery as the same incisions are used . In some cases, the rectus plication is not performed for one reason or another at the original surgery and a secoond operation is needed once the patient and surgeon decide to perform a plication. I hope this is helpful.

Daniel Kaufman, MD, FACS · Answer

Thank you for your question. Although it might be somewhat early to do a tummy tuck revision surgery, it is not that uncommon. The bulge that you describe can be due to a suboptimal muscle repair, or alternatively can also be an undiagnosed seroma, or fluid collection. Only your surgeon using a proper physical exam can make the proper diagnosis. The fact that you will not be charged a full price is great for you, and will help you out certainly. The pain and recovery should be easier than before since most of the dissection of the tissues has already been done and you as a patient are already aware of all the relevant postoperative issues. This, of course and again, depends on exactly what the problem is and what is done about it. Make sure that you get a formal opinion form a Board-certified plastic surgeon (if your surgeon is not one) to get the best assessment of the situation. Hope this helps. Good luck and fare well.

Francesco Campanile, MD · Answer

There
are a number of reasons why your initial tummy tuck didn’t give you the results
you hoped for, but very few of them occur after a well-performed surgery.
Although your plastic surgeon may be doing the right thing by offering to
perform a second surgery at a reduced price, I recommend seeking out a second
opinion just to be on the safe side. Possibly, it’s a straightforward issues
such as intrabdominal fat that’s interfering with your contours. But in that
case a second surgery isn’t the answer; weight loss is. A second consultation
will be far worth the effort if it means you’ll finally get the outcome you
deserve.

Michael A. Jazayeri, MD · Answer

The situation you have described is rare.
However, a second tummy tuck can be performed usually after 6 months.  This is to allow all the swelling to subside and the tissues to reach their pre-surgery softness.

Daniel P. Markmann, MD · Answer

In regard to your question about repeat Tummy Tuck safety - Yes, it is safe as long as you are in good health. Re-do tummy tucks are not that common. In my experience it occurs most often when patients lose more weight, get pregnant or when the original tummy tuck wasn't done to the patients satisfaction int the first place. This could be due to the skin not being tightened enough, or to the surgeon not tightening the muscles or not tightening the muscles enough. 
I do not think it is too soon to redo this surgery, Pain and recovery should wither be the same or maybe little less.

Victor M. Perez, MD, FACS · Answer

Without all the specifics of your case it is very difficult to give you a 100% accurate answer, however if I have to guess, one of the possible causes of your problem is the way in which your surgeon performed the muscle thightening. Sometimes the surgeon uses a running suture which is possible to brake after the surgery, if this happen the repair will fail.
Your surgeon should be able to explain this to you
Again the most important factor in the outcome of your surgery is the choice of your surgeon! Be sure your surgeon is a plastic surgeon certified by the American Board of plastic surgery. Good luck

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