Lower Abdomen Pooch After Tummy Tuck

Liposuction of the tissues above the incision are not generally performed at the time of the initial procedure due to concerns with interfering with healing. You may want to discuss performing liposuction with your surgeon at this point in time

Hello Projectbeautiful. Thank you for reaching out with your concerns about the persistent pooch in your lower abdomen following your tummy tuck 9 months ago.

It's not uncommon for patients to have concerns about the contour of their abdomen following a tummy tuck, especially if there are areas that do not seem to match their expectations or pre-surgical goals. Here are some considerations and steps you can take to address this issue:

Swelling: At 9 months post-operation, most of the swelling should have subsided, but it's not impossible for minor swelling to persist, especially in the lower abdomen where fluid tends to collect more readily. However, it's more likely that what you're seeing now is close to your final result.

Residual Fat Deposits: If the area is still firm and there is no muscle separation, the pooch could be due to residual subcutaneous fat. This is something that liposuction could potentially address. Liposuction can be used to refine the results by removing stubborn fat pockets that a tummy tuck may not have fully corrected.

Skin and Tissue Settling: Even though most healing happens in the first few months, the tissues and skin continue to settle and adapt up to a year or sometimes longer after surgery. This process can slightly alter the initial post-operative appearance.

Surgical Technique: The technique used during your tummy tuck and how your incision was closed could also influence the contour of your lower abdomen. Sometimes, the way the skin is redraped and sutured can create a firmer or more pronounced area along the incision line.

Next Steps:

Follow-Up with Your Surgeon: It's important to discuss this concern with your plastic surgeon. They can evaluate the area to determine if what you're experiencing is residual swelling, excess fat, or a result of how the surgical tissues were manipulated.

Consideration for Liposuction: If the issue is due to residual fat, your surgeon might recommend liposuction as a complementary procedure to refine the contours of your abdomen further.

Review Before and After Care: Ensure that you are following all recommended post-operative care instructions, including wearing compression garments if advised, to support the best possible healing and settling of tissues.

Patience and Monitoring: Continue to monitor the area as it can still change slightly with time. Taking periodic photos can help you see if there is gradual improvement.

Your surgeon will be your best resource to determine the appropriate action, whether it be additional time for natural resolution, liposuction, or other interventions. It’s also valuable to ensure that your weight has stabilized since fluctuations can affect the results of your surgery.

I hope you find a satisfying resolution soon.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

The concerns you have about the fullness of the lower abdomen could be from a number of different things including swelling or additional fat. I encourage you to return to your surgeon for an evaluation. At 9 months post op you are far enough out from surgery to consider liposuction if it is warranted.