Unsuccessful Tummy Tuck Centered Around Belly Button?

I'm 5 months post op tummy tuck with full tightening, one midline plication which seemed to hold up. Before surgery had severe abdominal distention but minimal diastasis. Still have distention but now have round bulging contour over belly button plus, to my surprise, a frowny horizontal belly button. Think my belly button stalk is now too short for the amount of distention I still have. The whole situation is bad and I'm uncomfortable. 95 pounds at 5'3" so no signifant fat. What to do???

Doctor Answers 4

Some reasons for the bulge after tummy tuck.

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Dear KeyLimePie,

From your photos and question, it's not totally clear whether  you had a mini of a full abdominoplasty. This makes a difference because if you had a mini, there is no plication done above the umbilicus, and sometimes this causes bulging in the upper abdomen. If this is the cause, then plication of the rest of the upper abdomen may be needed. You mentioned that you have no fat in the tummy, and this is why I am questioning what type of tummy tuck you had, since if you do in fact have no fat, the only other possibility would be abdominal bulging.

However, if you pinch the area and it does have a thick fatty layer, then liposuction should be considered. Keep in mind though that the 'horizontal' umbilicus that you are concerned about actually can get worse with liposuction.

Alternatively, if a regular tummy tuck was performed, it is is possible you have stretched out the muscle again. We see this in patients who have lots of intra-abdominal fat; their tummy tuck looks good at first, but then bulges out again after a few months. Thus, patients with significant intra-abdominal fat are not good candidates for tummy tuck). You did mention that you had significant 'distension' pre-operatively, so it is possible that the bulging is re-occurring but more in the upper than lower abdomen.


The other possibility is that the new umbilical opening that was made during you tummy tuck was made a little too low. Remember that the stalk is still in the same spot, so if the hole is too low, the stalk now points 'downwards' which can also give the appearance of overhanging skin or bulging just above the new navel opening (which corresponds to the stalk itself). 

Bottom line: without more info and an exam its impossible to way what the best action is. Follow up with your PS and have a frank discussion. Best of Luck.

Best regards,

Lawrence Tong MD FACS FRCSC

Toronto Plastic Surgeon

Several Possibilities

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I can detect a slight bulge of your abdomen. This could be;

  • Residual skin, or
  • Fat around your midportion, or
  • The muscles tightening was not adequate, or
  • You have a generalized weakness of your abdominal wall.
  •                        A weak abdominal wall; muscles and fascia gives way to the abdominal content and creates a generalized protrusion.

It is also important to know that once the belly button is designed and the incisions are made, it is unlikely that the shape or the depth can be altered significantly. Did you check you surgeons abdominoplasty photos and his credentials prior to your surgery?

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon

Liposuction will help

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You have central fat pocket and I would recommend liposuction with possible tummy tuck revision. The quality of your mid abdominal tissue will dictate the need for revision. The combination of the liposuction and tummy tuck would have been better choice for you.

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Unsuccessful tummy tuck?

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Thank you for your photos. Without preoperative photos it is hard to make a judgement how much improvement you attained from surgery. What I see is a supra umbilical, epigastric bulge. I would talk to your surgeon about liposuction of this area to improve your results and will also reshape your belly button to a more vertical direction. Good luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.