What is the Reasonable Expectation for "Flatness" After TT? (photo)

(10 Weeks Po, Still Swollen but Much Flatter when Laying Down).I have seen many surgeons on this site indicate to people that they will never be flatter than when they are on their back, but is there an acceptable difference between how flat a person is on their back and how flat they are when standing? Should the two be the same? Or does a person naturally get more rounded when they stand up? I am completely flat when laying down, but only round flat when standing (pics attached). I love my TT results, but should I ever expect to be completely flat?

Doctor Answers 5

What is the Reasonable Expectation for "Flatness" After TT?

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It is hard to discuss expectations and outcomes without seeing before pictures. And sitting pictures are not useful unless compared with pre-ops. When you are sitting, the chest moves closer to the pelvis. The TT surgery cannot restore lost elasticity, and the skin has to buckle. If you looked tight sitting, you would not be able to stand erect. 

A person does naturally get more rounded when standing,as the effects of gravity come into effect, pressing upon the abdominal muscles, which is not a factor when laying down. 

This does look like a nice outcome. All the best. 

Seattle Plastic Surgeon

Intra-abdominal fat may limit the flatness obtained by an abdominoplasty.

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Some patients store fat inside the intraperitoneal cavity and may make total flattening of the abdomen after abdominoplasty impossible. Discuss this with your plastic surgeon.

Achieving a flat abdomen

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Thank you for the question and the photos.  A completely flat abdomen does not have an excess of fat, excess of skin, or a looseness of abdominal wall.  Initially after surgery there is also swelling.  Once the swelling is gone one or a combination of the above should be evaluated as the source of the lack of flatness of your abdomen.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Before pictures would be helpful....

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It is hard to give you an accurate expectation without good "before" photos.  Although your results will get better with time, as you likely do have some swelling, you may not get to "fully flat".   Sitting photos do not really count.... Even the thinnest people will have buckling of their belly when they sit. 

I would say this looks like a nice early outcome, but "before" photos would help in our assessment. 

Gordon Lewis, MD
Midlothian Plastic Surgeon
4.8 out of 5 stars 23 reviews

Your great result will get better with time

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HI carlyburton.  Your pictures show a very nice early result.   When you lay down you abdominal contents are pulled away from your abdominal wall by gravity.  This effect flattens your belly.   When you stand, these internal organs fall down into your pelvis, and also press against your abdominal wall (in front, which is looser) and your spine (in back, which is more rigid).  Thus your belly buldges a little when you stand up.  I am sure this bulge is less noticable than it was before your surgery.   Your swelling will improve over the 3-6 months after your surgery, so I am sure your results will improve.

Lewis Ladocsi, MD, FACS
Richmond Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.