Due to weight loss I had an abdominoplasty three weeks ago. Now the skin is tight and flat, but my love handles are sticking out as thought they are very swollen - the problem is that I had no flank lipo - only skin was removed. So I am concerned. Is it normal to have this here, even without being stitched directly upon? As the photo will show, a few months ago my waistline was pretty flat, but now looks fat. What is going on?!
Swollen Love Handles Normal After Tummy Tuck?
Doctor Answers 9
Swollen Love Handles after Abdominoplasty
It is possible that you have some swelling in your love handles (flanks) after your surgery. However, it looks as if you would benefit form liposuction of those areas. As a standard procedure I liposuction the love handles of all the abdominoplasties that I perform. I feel that it enhances the results and prevents the issue that you are experiencing.
Abdominoplasty can leave fullness at the end of the scar
What you have are called "dog ears". When an ellipse shape of skin is removed, and the incision closed in a straight line, the two ends of the incision may pooch out as in your photo. This early after surgery, alot of this appearance may be do to swelling in this area. However, if this does not signficantly improve over the next several months, some revision procedure like liposuction may be necessary.
Larger "Love Handles" AFTER Weight Loss related Tummy Tuck
Judging by your photograph, it appears you would have benefited from liposuction of the love handles at the same time as your tummy tuck. It also appears as if there may be a step-off between the lower edge of the incision and the superior edge.
As the tummy tuck tightens the abdominal wall and flattens it, the waist is narrowed . This accentuates and make more obvious any excess fat along the love handles and hips. For this reason, liposuction of the hips / love handles is frequently done at the same time as a Tummy tuck.
During the tummy tuck, excess fat under the top skin flap is removed. Failure to do so results in an over-riding superior skin edge with mismatching of the wound.
I would let the wound heal for 6-8 months before considering a revision. It may look a lot better at that time.
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Love Handles bulging after tummy tuck
It does look like you may have benefitted from some liposuction... ON the other hand, it may also be that there remains some residual skin excess, or that because the skin that remains is of poor quality (because of your weight gain and loss history), you have this (possibly temporary) problem.
Rather than second guess your surgeon, I would recommend that you visit with them, openly communicate your concerns to them, listen to their thoughts and the plan for improvement, and decide how you would like to proceed.
I bet your surgeon wants you to be happy and will help you come up with a plan for maximizing your outcome.
Be patient for now
It's too early to judge whether this will remain a problem so at this point I'd advise you to be patient. If in the long term (after waiting at least 3 months) your "love handles" remain prominent, you should discuss with your plastic surgeon whether this is due to excess skin, fat, or a combination of both.
If you have excess fat and good skin tone, further liposuction may be all that is required but with your history of weight loss suggests you likely have loose skin contributing to the problem so you may need further skin excision extending posteriorly in the form of an extended abdominoplasty or possibly a circumferential lower body lift.
Blame it on the dog (ears): Extra love handle skin after tummy tuck
Any time a tummy tuck is performed the incision must end. Beyond the ends there is relatively excess skin that sometimes becomes engorged and more pronouced due to swelling from the surgery and redirection of lymphatic circulation due to the surgery. This dramatically improves with time. Rarely, it requires revision to remove excess skin.
Swollen love handles normal after tummy tuck
Dr Aldea's RX is 100% correct. Why no liposuction at the same operative setting as the tummy tuck? Maybe a mistake or poor judgement?
From MIAMI Dr. B
Love handles need to be treated with tummy tuck.
You will look better with time, but I would not be surprised if you need a revision in six months. When we do tummy tuck in Manhattan, we often correct the love handles at the same time with liposuction. This may have to be done. The other thing that can happen is that residual tissue is left at each end of the scar ("dogears"), and this has to be cut out later.
Swollen love handles
From your history, I suspect that the bulging over the love handle area is basically a "dog ear" whereby the tissues just lateral to the end of the excision gets bunched up. This is contrasted with the tighter profile of the "tucked" abdomen producing an exaggerated fullness.
The wider the angle at the end of the original excision, the greater the tendency for this bunching to occur. Depending on the examination of this area, the solution to minimize this is either to extend the excision around to the back and/or liposuction the bulge and undermine the surrounding soft tissue to allow the bunching to dissipate.