Is this a hernia? (photos)

Question

TT March 2022 In then had lipo to the upper tummy due to still being rounded and having a bulge, that was March (one year later) I’m still unhappy with the results - now 18 months post TT and 6 months post lipo. Due to go back to see surgeon but would like advice first. Amy advice re the swelling, bulge and roundness? Should I be a candidate for a revision if it’s a hernia? No hernia was mentioned at any examinations.

Camille Cash, MD · Answer

Your surgeon is the best person to advise you as she/he has examined you preoperatively and is familiar with how you've progressed through recovery.  If muscle repair was done and is still intact the rounded contour of the abdomen is likely from visceral fat.  This is fat behind the muscle wall that surrounds your organs.  It cannot be addressed through a tummy tuck or liposuction.  Only weight loss will improve it.  Your surgeon should be able to answer your questions after an exam.

Connie Hiers, MD, FACS · Answer

A hernia is usually diagnosed by an examination and a CAT scan if needed. You could ask your medical doctor or surgeon to examine you. If it is just residual fat, it can be removed with liposuction.

Mats Hagstrom, MD (license on probation) · Answer

To make a quality assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. If you don’t have proper before, and after pictures, then ask your surgeon to forward the pictures they took. If you’ve had more than one operation, and then you should include before and after pictures of each of the procedures.
The most common reason to have a bulging abdomen after a full tummy tuck, is access, visceral or intra-abdominal fat.
Individuals who have excess visceral fat, should be told that their abdomen may not become flat without weight loss, even with a full tummy tuck.
There are four tissue variables that determine what the abdomen looks like. If somebody doesn’t like their abdomen, whether they had surgery or not the problem, and is generally always going to be one of those four variables.The four tissue variables that determine what the abdominal looks like are the following.1) abdominal skin laxity2) excess subcutaneous fat.3) muscle separation from previous pregnancy.4) excess visceral or intra-abdominal fat.
Three out of the four tissue variables have been treated with your previous two operations, so the only one left is the visceral fat.
Weight loss is most likely going to be required to get the results you’re hoping for. I suggest dropping 5 pounds and re-taking pictures and compare. If weight loss works and continue losing weight until you get the shape of the happy minute you’re happy with.
An experienced plastic surgeon should have no difficulty differentiating the above for tissue variables.
Visceral fat can only be reduced with weight loss.
Best,
Mats Hagstrom, MD

Is this a hernia? (photos)

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Is this a hernia? (photos)

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