Is it common for some patients to need a second tummy tuck procedure?

Looking at your immediate post op appearance, you can be certain that your surgeon took as much skin as possible. It also looks like in the early post op period you may have had an infection and/or a collection of fluid in the lower abdomen. It is clear that you now have residual skin excess in the lower abdomen, something that could have happened even with ideal healing; persons who have had significant excess weight loss have skin that does not reliably stay tight, and can frequently benefit from retightening. There is no clear evidence that your suboptimal result was due to surgeon error or suboptimal execution. I don't know about you, but as a cosmetic plastic surgery patient myself, I wanted my surgeon to feel that his time and energy was properly remunerated.

Dear Charming908008,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It is occasionaly necessery to perform second abdominoplasty in patients whith very distended skin like yours was before surgery. Although your immediate postoperative result shows very tight skin after abdominoplasty, breasts as well, several months down the road, a lack of skin eleasticity is shown as secondary skin redundancy. In order to deal with this new problem, additional skin excision, possiblly with conservative liposuction, should be considered. This is not your surgeon's mistake but should have been discussed as a possibility before surgery. Good luck.

Considering where you started you have a great result. It’s not unusual for the abdominal scar to require a second procedure in which a bit more skin can be removed and the scar straightened out.

It is not typical that patients need a revision after a tummy tuck, but it can occur. From your description it seems you have good communication with your surgeon. I encourage you to discuss your thoughts with him/her. Your photos show that you have had significant improvement from your tummy tuck and now are going back to fine tune some things.

Great series of posted photos... This is a very difficult diagnostic/ethical issue. If the PS might have thought 2 rounds were needed then why was this NOR discussed initially - informed consent concept. I would offer you a revision full TT at my costs + small MD fee of $5,000-$6,000. Maybe you need to virtual consult with....

All plastic surgeons should have a certain revision rate.
How surgeons handle patients who need revisions is up to each individual provider.
It’s typical for plastic surgeons to Charge a surgical fee but to ask patients to cover anesthesia and operating room cost for revision procedures.
In your case you had pretty severe skin laxity access and in reality you were probably a better candidate for an extended or wraparound tummy tuck.
Removing that much loose skin with a limited scar length will lead to certain compromises.
It is also true that some people develop skin laxity over time while others do not.
Your early results clearly indicate quality work despite your long-term results not looking quite as good.
It’s easy to play Monday morning quarterback or second guess outcomes but the truth is all plastic surgeons have had similar experiences though it’s probably not the norm
It does appear that your skin laxity is related only to your lower abdomen and simply redoing the incision with removing further skin is probably sufficient.
Consideration to an extended tummy tuck taking the scar further back around your waist should also can be discussed.
I think your provider is perhaps being a little greedy trying to charge you money for an indicated revision which should probably not be charged for except for external expenses like facilities and anesthesia fees.
I can’t emphasize enough the importance of having thorough in person consultations before surgery and vetting providers adequately.
In the end it’s up to you whether you move forward and work with your current provider. To get an accurate second opinion consultation consider talking to other local board-certified plastic surgeons.
In the end your surgeon is responsible for your well-being and the outcome of the procedure and likewise you are responsible for having chosen that provider.
It’s important to discuss revision rates, revision policies and have a clear understanding of what each practice policy is.
For patients who have concerns over their final outcomes sometimes reviewing your before pictures and remembering where you started can put things in perspective as well.
Best,
Mats Hagstrom MD