Second opinion on small bulge above incision? (Photos)

Your surgeon is correct in that is the last place the swelling leaves is right above the incision. Your surgeon is also correct that not all the fat in that area can be removed with the tuck because of risking damage to the circulation of the skin. However, sometimes a small pocket of fluid forms and needs to be drained. This can be determined by examination. Otherwise, follow your surgeon's advice.

As your doctor said, intensive liposuction was not applied to that area in order not to disturb the blood circulation. I recommend completing the healing process (approximately 1 year), after which correction can be made with liposuction if necessary.

Thank your for your question! I agree with your surgeon with regard to the tendency of this area to retain edema for months after surgery. There are two common causes of persistent or recurrent lower abdominal bulging after an abdominoplasty. One is an untreated or recurrent diastasis recti (separation of the rectus abdominis muscles). If this is the cause, re-operation is necessary to perform a rectus plication. The second relates to the fact that, for many patients, there is a significant difference in thickness between the upper abdominal skin and fat (often 1 inch thicker) and the mons/groin skin and fat. These two areas are brought into contact when the upper abdominal skin is pulled down and your incision is closed. I disagree with your surgeon's statement that the upper abdominal fat cannot be safely thinned to match the mons/groin thickness during an abdominoplasty. I routinely perform this maneuver specifically to avoid the lower abdominal bulge/fullness and create a seamless transition during my abdominoplasties. At this point, I agree with waiting 9-12 months prior to a touch-up procedure to eliminate the effects of edema/swelling as much as possible so that when you have liposuction your surgeon can accurately thin the bulging area and create a natural, harmonious transition.