Has my muscle repair failed? (photo)

A muscle repair helps to tighten the abdominal wall and flatten the abdomen, but it will not make you perfectly flat if you have a lot of intra-abdominal volume.  Many patients don't understand the difference between internal and external fat.  Speak to your plastic surgeon to discuss your concerns. For more information about internal fat VS external fat please click my link. 

Thanks for your question.  You would need a proper assessment to help determine the cause of your swelling.  Generally speaking, swelling after a tummy tuck can last for months so it's feasible that you will see improvement for some time.

It is always difficult to comment without seeing the preop but it is likely that you have postop swelling that is not unusual. I would suggest seeing your PS again to run through your concerns but often this will settle over the coming months as long as you do not put on weight. 

I'm sorry to hear about the concerns you have after tummy tuck surgery. As you likely know, your plastic surgeon will be your best resource for precise diagnosis...

Generally speaking, abdominal wall your concerns after tummy tuck may be related to:

1. Swelling in the soft tissues. This may take several months to resolve and may worsen with increased activity or at the end of the day. Patience is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.

2. Fluid accumulation in the space between the skin and the abdominal wall muscle. this may consist of blood ( hematoma) or serum (seroma). This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound may be helpful). Treatment consists of aspiration; several episodes of aspiration may be necessary.

3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. One of the steps of a tummy tuck procedure involves reapproximation (plication) of the rectus muscles. These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline. Again, your plastic surgeon will be in the best position to accurately advise you and/or provide you with meaningful reassurance.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year (or greater) a complete skin redraping to occur. 
Best wishes.