I think there are really two questions here... the first is why this upper abdominal bulge is present in the first place. It may be that you are correct in your assumption that this is fatty tissue, and if this is the case, liposuction should successfully put the finishing touches on the result for you. It is important to know that this is, in fact what is causing the appearance you are noticing, though, because the other possibility is that you have a different problem that would require different management.
Of course, the only way to know for sure is to visit you surgeon for an exam. He/ she will also be able to advise you on the timing of the liposuction if needed- as the timing will depend on his/her comfort level with the blood supply to your abdomen after the tummy tuck (and he/she will be the only one with the necessary understanding of your tummy tuck to be able to answer this question).
Pay a visit to your surgeon and see what advice he/she gives you.
Wait 3 months for upper abdominal liposuction
Most traditional techniques for abdominoplasty (tummy tuck) tighten the muscular layer over the muscles in the upper and lower abdomen (we call this plication) as well as remove the lower loose skin (below the belly button) from the abdomen. Often, some liposuction is performed on the flanks and hips, but there are safety reasons as to why too much liposuction done in the upper abdomen can possibly affect the blood supply of the skin, for this reason many surgeons don't do a lot of thinning or liposuction at the time of the tummy tuck.
I tell all my patients that undergo a tummy tuck procedure that there is a possibility of a "2 stage procedure" with a 1 hour upper abdominal liposuction that I routinely schedule 3 months after the tummy tuck to further contour the upper abdomen.
I think it's great if you can lose weight with diet and exercise but even then not every patient will get contour improvement specifically in the upper abdomen (epigastrium). The good news is that you have come through the bigger part of the procedure, the tummy tuck, and even if you decide to have further contouring in the upper abdomen with liposuction to "bring your abdomen back into balance", it would likely be an outpatient procedure with a rapid recovery.
Hope this helps!
Some plastic surgeons do liposuctiong of that area at the same time as the tummy tuck, it works out great.
You need to know what your surgeon did. Was this a full tummy tuck, a mini, was there any liposuctioning done.
You should wait at least 6 months before proceeding to additional liposuctioning.
I would wait about 6 months after a tummy tuck before going back to the upper abdomen for liposuction. You want the tummy tuck to be fully healed, you want all swelling to be gone, and you want to give yourself a chance to reduce it through diet and exercise. If that fails, then by all means, go back for upper abdominal liposuction.
I would weight about 4-6 months for the swelling to completely resolve before having any lipo performed. You obviously would also want all the incisions to have completely healed as well before performing the liposuction.
This depends on how the upper abdomen was treated
Speak with your physician to find out if he already did some liposuction in this area and if the problem is really more laxity of the skin than it is residual fat deposition (lipodystrophy).
Having laxity of the skin in the upper portion of the abdomen after a tummy tuck is not unusual since most the pull is on the lower half of the abdomen. In some instances ,the laxity of the upper skin can be treated at the same time as the tummy tuck or at a later time through an incision in the inframmary crease of the breast ,where the upper abdominal skin is mobilized and sutured to the deep anchor tissue over the surface of the ribs with permanent sutures. I call this an "upper abdominal lift" and it has worked quite well for my patients.
Thinning out the fat in the upper portion of the abdomen during a tummy tuck, can compromise the blood supply to the abdominal flap so you may need some suctioned once the flap has healed. As a rule of thumb, most plastic surgeons will suction an area until the thickness of the skin on a pinch test is one-to fingerbreadths.
I am afraid diet and exercise won't help.
In New York City, we do liposuction of the upper abdomen at the same time as the tummy tuck. This is safe because we use a minimal undermining abdominoplasty technique, which preserves the blood supply.
But it is OK to do it in two stages. I don't think diet and exercise will work, because this is localized fat. Wait 4 or 5 months after your tummy tuck to do the liposuction.
You must speak to YOUR plastic surgeon.
We have not seen you, we have not operated on you - we are only guessing --- Your surgeon did the surgery and should be able to evaluate why you have an upper abdominal bulge, leave it up to him to assess you and tell you what can be done and when to do it.
4-6 months would be reasonable
After 4-6 months you will be totally healed with no swelling left. At that point, if you are still displeased, go ahead and discuss liposuction with your doctor.
The bigger question is...
Why doesn't your upper abdomen look as good as your lower abdomen? Why would you have to do a second abdominal procedure go get a good looking abdomen after abdominoplasty? See my links.