Bulging and Sore Abs Years After Tummy Tuck

I am two years post complete tummy tuck. My question is that my upper abdomen is still sore and bulges out over the lower. Should I be concerned? My surgeon has liposuctioned that spot after a year but I am still bulging.

I'm wondering if there is another problem that I should be concerned about. Not only am I sensitive in this part, I am also very asymmetric. Which was so called "fixed" a year ago. I am ready to seek advice from another surgeon. Please help?

Doctor Answers 5

Upper abdomen bulge after tummy tuck

It depends a bit on what your surgery involved and when you started noticing the bulge.

Abdominal contour is dependent on:
Skin envelope
Abdominal fat (subcutaneous and intrabdominal)
Muscles tightness
Intrinsic Swelling
Fluid collections

Skin Envelope -
People complaining of "abdominal bulge" after tummy tuck typically do not have issues with too much skin - that points to issues underneath the skin.

Abdominal fat -
This can be an issue in people who may be a little bit over their ideal body weight at the time of abdominoplasty. Ways to fix this include the tried and true diet and exercise or liposuction. Be sure to allow enough time between tummy tuck and liposuction to minimize complications.

Muscle tightness -
Muscles plication (or tightening) is usually a part of abdominoplasty. Either failure of the sutures or some laxity can cause a bulge. If the change in your contour was sudden or if you felt a pop - think about the plication having ruptured.

Swelling -
This can be the most common cause of contour issues post-abdominoplasty. Patients typically have swelling for two reasons. First surgery causes trauma and the body's response to trauma is to bring additional fluid into the area that has been traumatized. In addition, abdominoplasty involves dividing lymphatic channels (very very small conduits that normally pull fluid out of tissue) - until these channels grow back the area will not be able to remove excess fluid.
It is usually the most dependent (lowest) part of the surgery that stays swollen the longest.

Fluid collections -
Seromas (serous fluid collections) or hematomas (collections of old blood) can cause distortions of contour. Normally this will improve on its own but may require drainage.

In your case it sounds like the superior muscle plication may be a bit loose or has ruptured. That would account for the bulge and the asymmetry. This can be confirmed with a CT scan.

Correction would require additional surgery.

I hope this helps.

I hope this helps.

San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Persistent bulging of upper abdomen following tummy tuck

At this point, it may be worth a second opinion and possibly obtaining an imaging study to evaluate the cause for your bulging. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Upper abdominal bulge

Sometimes after a tummy tuck there is residual fullness int he upper abdomen. Without examining you, it would be hard to tell. This can be residual fatty tissue, loose skin to name a few causes. It can also be a diastasis if it was not corrected at the first procedure.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Upper abdominal bulge remaining after tummy tuck

Without an examination, I am just assuming that your tummy tuck was a "limited dissection" procedure that did not free the upper abominal tissues. Some surgeons call this a "mini-abdominoplasty". If your belly button was not repositioned, this is probably the case. You may benefit from a "full dissection" tuck with a new umbilical position. Best wishes.

Randy Wong, MD
Honolulu Plastic Surgeon
4.8 out of 5 stars 36 reviews

Upper abdominal swelling and soreness after a tummy tuck

Tummy tucks are a very popular and effective technique to contour the abdomen. During the surgery, we lift up your skin and fat layer and assess your muscles. If there is a separation of the muscles or some weakness, we commonly use sutured techniques to tighten the muscles and give you a smaller waist. There may be several causes for the bulging and soreness that you are experiencing in your upper abdomen. It is possible that this bulging may be a small collection of fat. It is also possible that this bulging may be due to some of the sutures having come undone.

Your best bet is to be evaluated by a board-certified plastic surgeon who has a great deal of experience with abdominoplasty antibody contouring. They will be able to assess your bulging and determine which procedure will help correct this mess.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

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.