Upper abdominal bulge after tummy tuck - will liposuction fix this? (Photo)

Thank you for your inquiry! It is hard to give a definite answer without a thorough in-office physical examination. There could be an area that would need a liposuction revision. If there are creases on your abdomen, it could be the way the compression garment is fitting. Schedule an in-office consultation with a Board Certified Plastic Surgeon and allow us to help you reach your goals.

Hello Powerful479374 in Tucson. Thank you for your question regarding the persistent upper abdominal bulge following your tummy tuck in February 2024.

The bulge in your upper stomach could be attributed to a few different factors, such as weakened or loosened rectus muscles or subcutaneous fat. An important factor to consider is whether your surgeon sutured your rectus abdominis muscles from the xiphoid process to the pubic region during your tummy tuck. This technique is typically used to flatten the abdominal profile postoperatively. If your surgeon did not perform this muscle suturing, or if the sutures have loosened, you might need to have the muscle plicated or resutured to correct this issue.

Alternatively, if the bulge is soft to the touch, it might be due to subcutaneous fat. In this case, liposuction could potentially be an effective treatment to remove this excess fat and improve the contour of your abdomen.

To accurately determine the nature of this bulge—whether it's due to muscle weakness, rectus diastasis, visceral fat, or subcutaneous fat—I recommend undergoing an MRI. This will provide a clear understanding of the underlying issue and guide the appropriate treatment.

Good luck with your continued recovery and addressing this concern. I hope this information helps guide you towards a successful resolution and achieving the abdominal contour you desire.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

You almost always need liposuction of the upper abdomen after a tummy tuck. That is why liposuction of the whole abdomen with BodytiteRF and Morpheus at the same time before having to get a tummy tuck will usually fix the problem nicely and prevent you from having to do a tummy tuck in the 1st place.

There are a few possibilities that could cause the contour of the upper abdomen that concerns you. It could be visceral fat. If that is the cause then losing weight would improve it. It also could be that this area was not repaired with the tummy tuck or not repaired adequately. The other option, which is not likely, is that it was repaired but the repair has failed. Your surgeon should be able to help you determine the issue.

The upper abdominal bulge occurs right after surgery due to the fact that with compression from the abdomen inferiorly will cause bulging superiorly. You may need plication on top which was not done or was inadequate. This may require a revision. If fat is present then this can be helped by liposuction but most likely you will need suturing of the upper part of the abdomen to correct the bulging.

Best Wishes,

Gary Horndeski, M.D.

Based on these photos it is very likely that upper abdomen was not aggressively treated with liposuction during TT. Additional liposuction of upper and lower abdomen will most likely correct this problem. Good luck.

An examination is needed to be certain, but liposuction can remove excess fat in the upper abdomen. This was not done at the time of the tuck for safety reasons to your skin, but it can be done now.

Dear Powerful,
Your description of an upper abdominal bulging post tummy tuck is not an uncommon one when the muscles have been tightened bunching up the skin and fat in the upper abdomen and the skin is not further undermined or released. We cannot determine from the photos whether your bulge is from intra-abdominal fat, or that bunching phenomenon. Your PS would have the best assessment of that, having been "in there." Have a discussion with him/her as to what could be causing it and if liposuction would be indicated. Good luck!

Based on the post of photos first step would be to get an ultrasound of the upper abdomen check if it’s fat or split muscle repair with a herniation? Depending on those outcomes if it’s fat liposuction could be done very easily otherwise if it’s a split muscle repair only full reopen tummy tuck with repair muscle impossible mesh or aBased on the post of photos for step would be to get a ultrasound of the upper abdomen check if it’s fat or split muscle repair with a herniation? Depending on those outcomes if it’s fat liposuction could be done very easily otherwise if it’s a split muscle repair only full reopen tummy tuck with repair a muscle impossible mesh, or a cellular dermal matrix supplied. Fees for liposuction with range from 3000 to 6000, if it’s a full reopen tummy tuck with a cellular dermal matrix the fees with rage from 8000 to 12,000. Best virtual consult with.

To make an accurate assessment regarding the outcome of any plastic surgery procedure, we usually need to see a complete set of proper before and after pictures.If you don’t have before, and after pictures, then contact your provider and ask them to forward the pictures they took. There are a few reasons why the upper abdomen bulge after a tummy tuckThe most common reason is individuals who have access visceral or intra-abdominal fat, which should been recognized during the consultation.Tightening of the muscle separation will cause increased abdominal pressure, and this is usually manifested as bulging of the upper abdomen. When that the weight loss is the treatment and the only treatment that will reduce visceral fat there by decreasing abdominal pressure.Excess visceral fat can usually be seen on before pictures or assessed during in person consultation.Another reason for fullness of the upper abdomen is insufficient undermining during surgery.Undermining is the process of separating the skin and fat layer from the muscle fascia. Skin tightening will only be accomplished on the skin and fat layer that has been separated from the muscle fascia.I need tissue above this will still maintain the laxity and accompanying fullness that laxity creates. The best way to assess if insufficient undermining is the cause is to pull up on the skin above the area of concern and see if it improves the contour.If pulling the skin tight in an upward direction above the fullness fixes the problem, then this may be the underlying cause.A third variable that can cause bulging of the upper abdomen is individuals who are barrel chested with a sternum that’s sits forward in relationship to the pubic bone.When that’s the case, muscle tightening causes an inward sloping of the abdominal wall with the upper abdomen appearing to bulge in relationship to the lower abdomen.Finally, the last common variable that causes bulging of the upper abdomen is simply insufficient muscle tightening.I suggest you follow up with your provider and discuss your concerns with him or her.Addressing many of these variables require redoing the procedure so sometimes accepting the outcome the way it is maybe the best option.Some of the variables are anatomically based and some are directly related to how the procedure was performed.Based on the information provided, it’s difficult to give you an accurate assessment.If you’re not getting the care you need from your current provider then I suggest scheduling a few in person second opinion consultation.The ability to make an accurate assessment and predict Why the results look the way they do is not always easy or straightforward.For a quality second Consultation patient should prepared bringing with them a complete set of before and after pictures and preferably a copy of your operative report.These can be obtained from your provider by requesting them.Best,Mats Hagstrom MD