Lower stomach is bulgy and hard 7 years after tummy tuck - is this scar tissue? (photos)

Question

I had a tummy tuck 7 years ago and for some reson one side of my stomach on my lowest look bulgy and feels a little hard can this be fixed ? Do I need a tummy tuck revisions ?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding your lower stomach bulge appearance and hardness seven years after your tummy tuck. A tummy tuck is like any other surgery; it heals with scar tissue. Some patients have a minimal amount of scars some patients have more scars. If liposuction is also performed during a tummy tuck, there is more chance of scar tissue creation. It is not unreasonable to expect scar tissue to last even seven years after a tummy tuck. You mentioned the areas hard, indicating that it could be scar tissue or firm muscle. Since you say this area bulges, it is probably not muscle and, therefore, scar tissue. I would suggest you visit with a plastic surgeon to evaluate the issue. You will probably need a revision tummy tuck, whether scar tissue, bulging muscle, or fat. The revision can eliminate prior scar tissue, tighten the muscle, and eliminate fat. If it is not a muscle issue, you may get by with liposuction of the fat and scar suction of the residual scar tissue. Either way, consult with your plastic surgeon. Thank you for your question regarding your lower stomach's bulgy appearance and hard seven years after your tummy tuck. 
Sincerely,
Dr. Katzen

Ozge Ergun, MD · Answer

It would be best to consult a plastic surgeon or your treating physician for a definitive answer, as they will be able to examine you and determine the cause of the bulge and hardness. It's possible that the bulge and hardness you're experiencing could be a result of a problem with the tummy tuck surgery, such as a muscle separation, or a build-up of fluid.

Geuris Cruz Quiroz, MD · Answer

Thank you for your question. Based on your pictures looks like scar tissue. During a tummy tuck specially in that part is not recommend to do liposuction to avoid complication as necrosis after surgery, and months after your tummy tuck you can have liposuction to fix the area. I recommend you to do a physical evaluation with a board certified plastic surgeon for better recommendations in your case. 
Best of luck!

Derek Fletcher, MD · Answer

Firmness of the soft tissues under your visible abdominoplasty scar is typically caused by one or more of the following: 1. Edema fluid collecting in the soft tissues due to the injury of the operation and interruption of normal lymph flow. This is usually an early finding that corrects itself within the first 6-12 months as lymphatic channels develop across the scar to reach the lymph nodes basins in the right and left groin to drain the fluid.2. Seroma, which is a collection of fluid like a lake between the muscles of your abdominal wall and the soft tissues under the skin. This is typically an early complication that can be managed with a needle and a syringe to aspirate the fluid. 3. Fat necrosis of the tissues under the scar. If the fat at the level of your visible scar was damaged, it will calcify and become firm and sometimes painful
An in person exam will help determine which of the above is contributing to your symptoms. Occasionally, an ultra sound can help increase the accuracy of the diagnosis. Seeing an experienced board certified plastic surgeon is the first step to making the right diagnosis and plan.

Daniel Barrett, MD · Answer

Dear Girl power 619,
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

Connie Hiers, MD, FACS · Answer

You will need to be examined to see what might be the problem. You may have an unresolved seroma than has developed into scar tissue or you may have some fat necrosis.

Camille Cash, MD · Answer

An in person evaluation is recommended to assess the area that concerns you.  If it is a fatty pocket it could be addressed by liposuction.  Include in your discussion when you first noticed it and if it has changed at all since then.

Douglas Taranow, DO, FACOS · Answer

The area you are concerned with is most commonly excess skin and fat, however, if this is true, it is usually soft.  The fact that it is convex (outward) and firm leads me to think it is either the lower muscle which needs tightening, or possibly scar tissue??
A physical exam would answer either of these scenarios.
Best wishes.
Dr, Taranow

Darryl J. Blinski, MD · Answer

Based on posted photos you need first an ultrasound examination of lower abdomen to see if scar or fat or both? Revision fee $6,000. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

It’s hard to make an assessment based on your pictures. I suggest you post proper before and after pictures. If you don’t have before and after pictures and ask your surgeon to forward the once they took.
Pictures should be taken from about 8 feet away having someone else take the picture or use the timer on your camera. Stand in a neutral position showing your body from your shoulders to your knees wearing undergarments. pictures should show your front, both sides and back side.
The most common reason for bulging of the abdomen after a tummy tuck is excess visceral fat pushing against the muscle wall.
Your pictures make it difficult to make an assessment.
All people have inherent asymmetry in their body. The baseline asymmetry is generally based on skeletal structure. Both the rib cage and the pelvis can be significantly asymmetrical.
The muscle wall can protrude differently on each side as simple baseline which may have been present before surgery.
People often do not assess their body critically before plastic surgery operations.
Follow up with your provider or have second opinion in person consultations with other plastic surgeons in your community.
Best,
Mats Hagstrom MD

Lower stomach is bulgy and hard 7 years after tummy tuck - is this scar tissue? (photos)

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