Why Does my Upper Abdomen Still Protrude After my Abdominoplasty?

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.   

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