Why Does my Upper Abdomen Still Protrude After my Abdominoplasty?

Why Does my Upper Abdomen Still Protrude After my Abdominoplasty?
I had a full TT (based on Operative Rpt) 4 years ago and from the beginning, my lower ab was flat but my upper ab still protruded significantly. No lipo was done. I have not gained weight, am 52 and in good shape. The surgeon says it's because the volume in my ab. is too great to be contained in a smaller cavity and pushes out. How do I find out if this is the case and if there's any remedy-additional tightening or lipo for instance? Many thanks for your response!

There are several reasons for a bulge in the upper abdomen immediately after surgery.  It could be that the upper abdominal muscle were not tightened enough or the lower abdomen was made more tight.  It could be that there is more upper abdominal fat that would benefit from liposuction.  It could also be that the muscle were overtightened but the skin flap was not undermined enough leading to a bulge.

A good exam could shed some light on your situation and could determine if anything can be done.

Good luck.

Fullness or protrusion of the upper abdomen after a tummy tuck is likely due to excess intra-abdominal fatty tissue. This is fat that is deep to your abdominal muscles and can not be addressed by surgery.  The only way to address this is to lose weight. The tummy tuck procedure likely tightened your abdominal muscles, but if you had some excess internal fat before surgery, this is still pushing against your abdominal wall creating this somewhat unnatural appearance.

I would consult with a board certified plastic surgeon in your area and be sure this is not due to a weakness that may have developed in your abdomnial wall over the years.

Best wishes,

Dr. Bruno

You could find out using an MRI or CT imaging but that is essentially unnecessary. Seek a second opinion to confirm your surgeons findings.

Without seeing photos there is no way to tell what is your problem.  I would see a doctor for consultation.

It sounds like your surgeon may be  in part suggesting excess intraabdominal fat  contributing to upper abdominal fullness.  An abdominoplasty responds best when the problem is more one of excess skin and muscle laxity then an overall distended shape secondary to intraabdominal fat.  If your abdominal fullness did not correct when lying down, this might in fact  have suggested intraabdominal fat , and not a surgical problem.   

A tummy tuck is great for removing extra skin and fat from the lower abdomen and for tightening the muscles in the upper and lower abdomen.  During a tummy tuck, I do not liposuction the UPPER central abdomen at all, due to blood supply issues (the blood supply from the upper abdomen is needed to heal the lower abdomen after a tummy tuck). If you have extra fat creating thickness in the upper abdomen, this is something to be addressed with liposuction about 3 months before or after a tummy tuck. If there is excess INTRA-abdominal fat, though, this must be addressed with diet and exercise.

Regarding;  "Why Does my Upper Abdomen Still Protrude After my Abdominoplasty?
I had a full TT (based on Operative Rpt) 4 years ago and from the beginning, my lower ab was flat but my upper ab still protruded significantly. No lipo was done. I have not gained weight, am 52 and in good shape. The surgeon says it's because the volume in my ab. is too great to be contained in a smaller cavity and pushes out. How do I find out if this is the case and if there's any remedy-additional tightening or lipo for instance? Many thanks for your response!"

Respectfully, IF your lower abdomen was flat and upper abdomen protruded "significantly" immediately after the Tummy Tuck it SUGGESTS that EITHER the upper abdominal muscles were not tightened as much as they could have been OR that you had a significant amount of fat under the skin in that area which would NOT have been flattened with a Tummy Tuck but could now possibly be made better with Liposuction. (If on the other hand, the upper abdominal fullness appeared later, that would suggest a breakage of the upper abdominal muscle stitching and a recurrence of the muscle separation).

Dr. Peter Aldea

There are at least 2 possible explanations for your continued upper abdominal fullness after your tummy tuck.  Mant plastic surgeons are conservative with or unwilling to perform liposuctuction of the upper abdomen with TT since this is the route of the new blood supply to the remaining abdominal skin.  If this is the source of your problem, you certainly could undergo lipo at this time.  However, if the source is intra-abdominal fat, there is nothing other than general weight loss which will address it.