What is this bulge 6 months after my mini tummy tuck/hernia repair? (photos)

Hello @merebeene83, thank you for your question. It is important to take into account several aspects among which is the surgical technique applied, and to evaluate if there is something else at a systemic level. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Dear merebeene83,
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

Thank you for sharing your question and photographs. At times when tightening the muscles it will pull skin in from the sides towards the center of the abdomen. If the skin is not released sufficiently it may result in a skin bridge/bulge developing. I would discuss with your surgeon or seek out second opinions with in-person consultations.

If it is just excess skin from removing the fat, then you could consider minimally invasive radiofrequency skin tightening with Renuvion or ThermiTight to help tighten the skin.

It's difficult to know what may be causing the abdominal contour that concerns you without an exam or knowing more about your procedure. I encourage you to visit with your surgeon for an evaluation. The correction will depend on the nature of the bulge.

During a tummy tuck, the skin and fat layer is separated from the muscle fascial layer, which allows the abdominal wall to be re-draped with a tight smooth abdominal skin/fat layer. It is the process of separating the skin and fat layer from the fascial that allows us to pull the skin tight. The process of separating the tissue layers is called undermining. Typically during a full tummy tuck undermining is done starting at the incision line down in the groin area all the way up to the rib cage. In some cases undermining is and should be continued up onto the rib cage right up to the inframammary fold of the breast. The degree or how far the surgeon undermines has a big impact on the aesthetic potential of the procedure. Degree of undermining also has safety implications and other variables surgeons need to take into consideration.
During a mini tummy tuck undermining is either not done at all or done up to the point of the belly button. Most likely your skin fold it’s related to the extent or degree of undermining. Surgeons not only have to decide how far undermining should be done going up towards the rib cage, but also along the sides. We cannot separate skin and fat layer from the entire body, because this would cause major wound healing complications. We can’t really tell you with perfect accuracy exactly why the skin fold is there but it’s probably related to the degree or how undermining was done in comparison to pulling the skin tight. The skin behaves differently while it’s still attached to the underlying fascia compared to skin that has been undermined. Occasionally results look fine on the operating table when patients are laying on their back. Later on patients are standing up and healing has begun and the abdominal contour may appear different than it did during the time of surgery. I would avoid finger-pointing and instead focus on the overall general improvement from where you were pre-procedure.
All plastic surgeons have had some cases which in hindsight, they recognize perhaps they could’ve done things a little differently. Sometimes these things are not noticed or were not noticeable during the procedure itself.
Best,
Mats Hagstrom, MD