Loose skin and bulge 2 years post tummy tuck. Would I benefit from a revision? (Photo)

Question

I had a tummy tuck two years ago, I have continued to maintain a very healthy weight however, I still feel like the doctor could have done more. I seem to have a lower belly bulge and excess skin. Would I benefit from a tummy tuck revision? Did the doctor go to ‘natural’ on me? I’m not happy with results and the dr told me to do more plank holds and Pilates. Looking for advice

Randal Haworth, MD, FACS · Answer

Sometimes, especially with big abdominoplasties, revisions are required to obtain the optimal result. A revision may  just entail liposuction and/or further skin excision. Rarely, the muscle plication may be disrupted resulting in bulging of the deep abdominal wall musculature. In this latter case, the plication sutures will need to be replaced.
I suggest you re-consult with your original plastic surgeon or get a second opinion from another board-certified plastic surgeon.

I hope this helps,
best of luck !

Daniel Barrett, MD · Answer

Dear amommymakeover,
it is hard to tell for sure without an examination. Based on your photos, it looks like there is not much loose skin. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You might do well with liposuction to remove some excess fat. Fat in that area cannot be removed at the time of the tuck because of potentially damaging the blood supply to the skin.

Camille Cash, MD · Answer

An exam is needed to give more information, but your photos indicate that a revision would improve your results.  If visceral fat is causing the abdominal contour shown then you will need to consider weight loss, as internal fat is not treated with a tummy tuck or liposuction.  A revision will address the loose skin, subcutaneous fat, as well as any abdominal wall laxity.

Mats Hagstrom, MD (license on probation) · Answer

It’s difficult to assess the outcome of a procedure. Your proper before and after pictures shows a fairly flat abdomen but the other pictures you show show of the abdomen is bulging.
The most common reason for a bulging abdomen after a full tummy tuck is due to excess visceral fat. Your preop picture does not show as someone who has visceral fat, so I wonder if you may have gained even a slight bit of weight from the date of your procedure?
Perhaps your provider could’ve been more aggressive. It’s hard to know without an examination.
Excess visceral fat is the number one reason that patients have a bulging abdomen after a tummy tuck with muscle tightening.
I suggest having a few in person second opinion consultation. Ask your provider to forward all of their before and after pictures and bring those with you for the assessment.
Best,
Mats Hagstrom, MD

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