Bulging and Unsatisfactory Tummy Tuck Result
From your data, on the day of surgery you weighed 220 pounds with a BMI of 40.24 (which still qualifies as Morbidly obese). Your IDEAL weight should be 110 pounds. For great results, you should have had a BMI under 30, preferably in the 23 to 27 range.
At this point, you will need to allow the healing process to continue and work on losing weight with good dietary habits without depriving yourself from proteins needed to bring about healing.
Liposuction of the upper abdomen may be done in the future to deflate the upper abdomen but would probably be accompanied by some skin sagging.
Ideally, If your weight comes close to the 110 range, you may develop skin sagging and another tummy Tuck procedure may have to be done at that time. That would get you the result you really wanted.
Dr. P. Aldea
It is possible that you still have subcutanous fat and intra-abdominal fat that is contributing to the huge upper abdomen.
Also the upper abdomen may not have been tightened strongly because of the lap band as your surgeon told you.
Your BMI now is 40.2 Your ideal situation is to drop to 150 lbs. Then re-assess the abdomenial fat, muscle strength and may need redo of the abdominoplasty.
Good vs bad candidates for tummy tuck
At 5'2" and 220 lbs you were not a good candidate for a full tummy tuck. Maybe a lesser procedure called a paniculectomy was what you really had where the lower abdominal apron is cut off and the upper abdomen is left alone. After you lose another 80 pounds or so, you could have a full tummy tuck and get the upper abdomen tighter.
Three possibilties for huge upper belly afer Tummy Tuck
Your abdominal contour can be explained by three things, or some combination thereof:
1. Persistent subcutaneous fat
2. Persistent muscular wall laxity
3. Intraabdominal fat
Your surgeon's ability to tighten the muscular wall and perform lipo may have been compromised by the presence of the lap band. Sometimes, relatively greater tightening of the lower abdominal muscles may make the upper abdomen appear proturberant by comparison.
Intrabdominal fat can only be addressed with weight loss.
If you are disappointed, discuss this with your surgeon who can tell you if additonal surgery can provide any additional benefit.
You may benefit from additional liposuction after you heal.
Often times during tummy tuck there is a reluctance to do liposuction to the upper abdomen. This is a necessary evil as doing liposuction to this area at the same time can often lead to decreased blood supply and wound breakdown especially when removing large volumes of fat like you had done. You also may have a significant component of fat inside your belly that will not respond to liposuction or a tummy tuck. It will respond to further weight loss.
Sounds like you need to loose weight
With your weight and height, it seems as if you were not an ideal candidate for an abdominoplasty. If the panus is gone, and your muscles are tight, then the tummy tuck was successful, but you are too heavy and need to loose weight. The fat you are complaining about is probably inside your abdomen and it is never corrected with a tummy tuck -- only diet and weight loss can help.