There are four tissue variables that determine what the abdomen looks like. In other words if somebody doesn’t like the way their abdomen looks it is always because of one or more of four different tissue variables. Tissue variables that determine what the Abdomen looks like are. 1) abdominal skin laxity typically due to previous pregnancies or weight loss2) excess subcutaneous fat3) muscle separation from previous pregnancy4) visceral, or intra-abdominal fat Considering you’ve had a tummy tuck, and Liposuction, the only two variables that could potentially be causing a bulging abdomen, is inappropriate muscle tightening or excess visceral fat. Failure of muscle tightening is unusual and visceral. Fat is the most common reason for patient to have a bulging abdomen after a tummy tuck. Ideally providers should make an accurate assessment during the initial consultation Explaining each of these variables and how the result will look based on patients having excess visceral fat on examination. Results are fairly predictable based on the clear understanding of which variables are causing the problem. Individuals who have excess visceral fat, should be told that without weight loss, the results will be inherently limited. While insufficient muscle tightening is potential, it is unlikely to be the reason your abdomen is bulging. Most likely this is due to access, visceral fat. I suggest taking baseline pictures and attempting weight loss. Take new pictures if you experience weight change and you will soon enough know what weight you need to be to get an abdomen Consistent with what you want. While Weight loss is easy easier said than done. It is most likely the only way to get a flat Abdomen in your case. Best, Mats Hagstrom, MD