Muscle repair failure after TT in July 2022. Tummy tuck revision or liposuction to get rid of the fat that sticks out? (photos)

I'm sorry to hear that your muscle repair failed. From the photos it appears you have abdominal wall laxity. That would not be corrected with liposuction. You can consider liposuction for now to get some improvement as long as you understand what you can expect in terms of results and are okay with it.

Liposuction is a good option now because it removes the excess fat that could not be removed during the tuck for safety of circulation to your skin. Once gone, you may be fine. You can also consider EMSculpt treatments with no downtime to help strengthen and tighten your muscles. It works very well.

To make an assessment regarding the outcome of a plastic surgery procedure we need to see a complete set of proper before and after pictures. If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took.
There are four tissue variables that determine what the abdomen looks like. In other words, if somebody doesn’t like the way, their belly looks it is always because of one or more of for different reasons or tissue variables.
The four tissue variables that determine what the abdomen looks like are as follows.
1) abdominal skin laxity due to previous pregnancy or weight loss2) excess subcutaneous fat3) muscle separation from previous pregnancy4) excess visceral or intra-abdominal fat
The most common reason for people to bulge after a full tummy tuck is excess visceral fat. Ideally, this should be determined and identified during preoperative consultations. The appearance of muscle separation and excess visceral fat is fairly similar. An experienced plastic surgeon should have no difficulty differentiating individuals who have a visceral fat and or muscle separation. The two can look similar, but can be differentiated.
One way to differentiate if the problem is visceral, fat or muscle separation is the lay on your back and see if your abdomen goes completely flat. If the problem is related to muscle separation, then your abdomen should go completely flat with no bulging whatsoever while laying on your back.
If the abdomen still bulges while laying on your back, and the problem is more likely to be related to excess visceral fat, rather than persistent muscle separation.
Another way to assess the difference it’s just see how much pressure it takes to press your abdominal wall flat.
A flat abdominal wall should be a beeline between your sternum and your pubic bone. If you can press your abdomen flat using your nondominant hand only and this does not take a lot of pressure then visceral fat is probably not contributing a significant amount. On the other hand, if it takes a significant amount of pressure to make your abdomen flat and doing, so makes it feel like your abdomen is full and it’s hard to take a deep breath then visceral fat is probably what’s causing the problem.
Visceral fat should be identified during your consultation, and we could probably determine if you had visceral fat if you would include it before and after pictures.
Visceral fat can only be reduced through weight loss.
Another determining factor that would indicate visceral fat is if you had a complete flat abdomen before your first pregnancy. If you’re at the same weight as you were pre-pregnancy, and your abdomen used to be completely flat, then the chance of having a problem with visceral fat is less likely.
A full tummy tuck primarily treats abdominal skin laxity, and muscle separation. Liposuction will reduce subcutaneous fat. Excess visceral fat can only be lost through weight loss.
Differentiating between the different variables and understanding what each procedure can, and cannot accomplish. Is it rocket science and most experienced plastic surgeons should be able to guide you through the process.
Results should be fairly predictable in the hands of a sufficiently experienced provider.
It’s pretty unusual for muscle, tightening to fail. What’s much more common is undiagnosed, or under diagnosed excess visceral fat during the preoperative consultation.
It’s important to differentiate between each of these variables, because having the procedure done twice, if you don’t need to is an unnecessary invasive surgery that can lead you worse off than you are now.
Best,
Mats Hagstrom, MD