4 Months Post Tummy Tuck: Uneven Love Handles

I am sorry you are not happy with your results thus far. No surgeon who does a properly-performed operation in good faith wants an unhappy patient. You are that patient, and perhaps your open dissatisfaction has put your surgeon on the defensive. Perhaps your surgeon's inability to make you feel better about what has transpired has made you even more unhappy. Truly, a nasty chain of events!

Your results clearly show what you are concerned about--more of a visible loose-skin "dog-ear" on your right hip roll ("love handle") than on the left. Since your belly is tighter from the skin removal, where the skin removal stops on the sides is where the skin feels the loosest. Your surgeon only took away--nothing was added, and swelling has largely resolved by 4 months post-op, so any residual looseness is what was there before, and can only be reduced by extending your incision posteriorly (towards your buttocks) and taking out more skin. Perhaps a bit more on your right side, but there will always be more looseness just beyond the extent of your incisions where all the skin remains, compared to the front where more was removed. That is the nature of a tummy tuck, and can be avoided only by a full circumferential belt lift or lower body lift (for patients whose loose skin extends all the way around). But taking a bit more skin will improve things nicely and will help to reduce your concerns with these areas.

You may also  have some residual lymphedema in the lower abdominal skin just above your scar--this tends to get better over 6 months or longer, but in some cases can be improved by liposuction, just as additional skin removal in the "love handle" areas can improve your skin tightness and symmetry in these areas. It seems as if you and your surgeon did not have agreement on realistic expectations vs. what was delivered, as it appears as if your results are absolutely fine by normal surgical standards, yet fell well short of your expectations.

Sometimes this is the "fault" of the surgeon who promises much and delivers less than "the moon and the stars." Sometimes this is the "fault" of the patient who is all agreeable and smiles during the consultation, but really fails to hear that there will be scars, swelling, possible "dog ears," and possible need for touch-up or revisional surgery (not to mention complications, which you didn't have). Did you and your surgeon discuss touch-up surgery, and who pays for what? I do this with every one of my patients, so everybody is on the same page when situations like yours occur.

You should go see your surgeon, thank him or her for what has been achieved on your behalf and then admit your dissatisfaction without "blame" or anger. Your surgeon really wants you to be happy, and is much more eager to re-operate on a reasonable and appreciative patient than one who seeks to "blame" or imply "fault" so as to assign "responsibility" for cost of re-operation on the surgeon. This is not your fault, but neither is it your surgeon's, and you should be willing to pay reasonable costs for revision surgery (I doubt there will be any surgeon's fee assessed, but the cost of anesthesia and operating room facility are reasonably yours, even if your surgeon has his or her own office surgical facility). Good luck and best wishes!

Your picture demonstrates a biologically active situation.  This must be allowed to settle.  Asymmetry which persists after this may be due to unequal fat removal which will need a bit of liposuction.  There might be asymmetric amounts of remaining skin that would require some skin removal for balance.

II truly regret your disappointment with your surgery but it is impossible to ethically blame your surgeon based on a single AFTER photograph presented above.

In fairness, we would need to see several BEFORE and several AFTER views to exactly see what your surgeon tackled in producing your current result. You obviously now show asymmetry between the right and left hips. We are all asymmetrical and most commonly the asymmetry was present before surgery. Asymmetry is the rule of nature. (For this reason, many Plastic surgeons tape the BEFORE pictures on the wall of the OP so they can consult them during surgery).

It appears you had a significant amount of fat under the skin which leads to the step off over the incision. A significant amount of this is due to swelling which will continue to decrease and you should see the final result by 6-8 months at that time liposuction of the flanks and step off may vastly improve the appearance and get you the result you were expecting.

Good Luck.

Peter A Aldea, MD

Improving the symmetry of your abdomen and “love handle area” should be possible with revisionary surgery. This will likely involve further excision of skin and subcutaneous tissues, probably requiring extension of the existing scar further to the back. Liposuction may also be helpful, in addition to further excision of skin on the sides.

Communicate your concerns clearly and realistically with your surgeon. Best wishes.

You photographs do show the unevenness that you describe. Although all sugeons strive to get a good result somethimes additional surgery may be necessary to help you get to a place where you can be happy. I would discuss you concerns with your surgeon and see what he has to say.