60 yr old female, 4'10", 148 lbs - is my fascia too stretchy & nothing can be done? (Photos)

Thank you for your question regarding what can be done for your abdomen one year after a tummy tuck. In regards to your specific case, I would suggest mesh supplementation. Additionally, you may want to consider insertion of mesh, as it could help anchor your abdominal wall. A large piece of mesh may be required to get your abdomen flat, possibly an 8“ x 10“ piece to get complete repair of the rectus fascia. You've come a long way from your before pictures. However, I think by inserting mesh, you will have optimal results. I hope this helps answer your questions regarding what can be done one year after a tummy tuck with fascia that is too stretchy.

Sincerely,
Dr. Katzen

I agree with you that this is disappointing, however there may still be some things you can do.

I recommend you tighten the muscle and fascia layer as much as you can with exercise to strengthen your core. This will be a gradual process, and can help flatten the tummy. You may want a personal trainer to assist you with finding the right exercises.

To go along with this, my second suggestion is to loose a bit of weight. The reason I suggest this, is that intraabdominal fat can make the abdomen bulge and appear bloated.

I agree that more surgery will not be helpful.

On a positive note, I do see improvement from your pre-op photo.

All the best to you,
Dr. Nancy de Kleer

Dear Sincere219028,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I'm sorry to hear about the difficulties you have experienced after your tummy tuck procedure. It's understandable that you feel sad and frustrated with the outcome.

Firstly, you might consider seeking the opinion of another plastic surgeon or specialist to obtain a third opinion. It's possible that there might be some options available that the previous surgeons have not considered.

Secondly, it may be helpful to speak with a therapist or counselor to help you process your feelings about the situation and provide some support during this challenging time.

Thirdly, you might consider exploring alternative treatment options, such as non-surgical procedures, to address the fluid retention and bloating that you are experiencing.

Lastly, it's important to remember that your worth and value are not tied to your physical appearance. You are a valuable and unique individual, and it's important to focus on self-care and self-love as you navigate this situation.


I hope this helps,
best of luck !

You probably could get some good benefit with nonsurgical, no down-time EMSculpt treatments to help thicken and build your abdominal muscles to pull in your abdominal wall and strengthen your core. As you age and things get weaker, you can even do maintenance treatments of one every 3-6 months if needed. EMSculpt is amazing!

I'm sorry to hear of your frustrations since surgery. If the muscle repair has failed a revision is needed in order to correct it. If the contour is from visceral/internal fat then weight loss should improve your results. I encourage you to visit with a board certified plastic surgeon near you for an evaluation.

To make an accurate assessment on the outcome of a plastic surgery, procedure and proper before and after pictures. I don’t have before and after pictures and ask your surgeon to forward the ones they took. Not having access to your before pictures significantly limit our ability to assess the outcome. The before pictures tell us what your candidacy for the procedure was Held at understand what was possible with this operation.
The number one reason patient have bulging abdomen after a full tummy tuck in the due to excess visceral fat. This can often be identified on preoperative pictures and gives a predictable outcome. If present it should be identified and patient should be told that without losing weight and reducing visceral fat result will be limited. Failure of muscle tightening is possible but rare and exceedingly rare an individual will have no excess visceral fat.
I suggest trying weight loss and I think you’ll see a significant improvement. Try retaking pictures after 10 pounds of successful weight loss if that makes an improvement and continue moving to another 5 to 10 pounds.
There are four variables that determine what someone’s abdomen looks like. If someone doesn’t like the way the abdomen looks weather they’ve had surgery or not the problem is generally always related to one or more of those four variables.
The Four variables that determine what the abdomen looks like are abdominal skin laxity, excess subcutaneous fat or excess visceral fat.
Failure of muscle tightening is unusual, and typically only happens if muscle tightening was done with a single running suture, and that suture breaks.
To differentiate if the bulging of your abdomen is do to fascial weakness, or visceral fat, you can try the following diagnostic techniques.
First, please lay on your back and see if your abdomen goes completely flat. This means your abdominal skin should be below a straight line between your sternum and your pubic bone. If it’s still bulges, when laying on your back, then visceral fat is contributing.
The second technique is the press your abdomen until it’s lined up between your pubic bone and sternum with your nondominant hand. If that takes a lot of pressure then visceral fat is contributing and is the primary cause.
Best,
Mats Hagstrom MD