Is an Upper Abdominal Bulge Normal 3 Months Post-Op Full TT? (photo)

I am 3 months po FTT with muscle repair. I notice in my mid line of my upper abs there is a bulge that makes my stomach more rounded instead of flat. I asked my PS about it and he said that I am so skinny that the repair is more obvious in me. Is there anything I can do to flatten it out? Is this normal? I can feel where the repair is and there is no extra bulge when doing a sit up or a dip in. To me it's more rounded at the top then before surgery. The bottom is definitely better than it was.

Doctor Answers 8

Concern About Bulge After Tummy Tuck

I have been impressed that many bulges seen three months post surgery are gone in six to nine months post surgery.  Therefore, when you ask "is this a normal situation?", the answer is that it is more common than you might imagine.


Tummy tucks, and especially the correction of separated abdominal muscles, lead to significant swelling when these muscles are sewn together, and this swelling often takes many many months to resolve.  The swelling you are referring to probably will go down in the next couple of months, and if it doesn't resolve entirely, it certainly will improve. 


Since when you lay down and lift your legs, there is no excessive bulge in this area, then this indicates that the rectus repair was adequate.  And since you are so thin, it is unlikely there was excess fat in this area, therefore time and exercise should cure your problem or at least relieve it significantly.

Upper abdominal bulge post tummy tuck

It is hard to see any significant deformity in the photos you have posted. The result looks quite good and acceptable to me. 

Expectations are everything in all cosmetic surgeries and it is hard to know what was discussed. Patients and doctors alike want perfectly flat abdomens, but this is not  achievable in all cases. As a surgeon, some tissue will simply not hold in weak abdominal wall structures. Many patients don't realize the vast differences and variability in tissue quality among different patients. For example, tissue like Kevlar would hold sutures well and could be tightened much more than wet tissue paper. So people with poor tissue will not be as tight and flat as others. 

That being said there are also technical issues which can cause bulges such as not freeing up the upper part of the abdominal soft tissue away from the muscle that is being tightened.  Tightening of the muscle superiorly can bring some tissue with it toward the middle of the abdomen, if it is not released properly. This can cause upper abdominal fullness. Also the upper abdomen can just not be tightened all the way up to completions, leaving a bulge in the muscle / abdominal wall looseness. Neither of these seem to be the case with you, based on your photographs, but these are common causes of upper abdominal fullness after tummy tuck. 

I believe you will improve over time. Good luck and best wishes. 

Jay Burns, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 46 reviews

Upper Abdominal Bulge After Tummy Tuck

The bulge seen above the belly button in the midline below the rib cage after a tummy tuck can occur for two reasons. The first is that the muscle repair may not have been done all the way up to just below the xiphoid process, the upper end of  the fascial sutures may have slipped or become loose, or the fascial repair was not done as tight as it could have been in this area. This makes the area of maximal abdominal wall tightening at the belly button and below, creating a very flat lower abdomen but some evident bulging up high. When this occurs, it is much better to simply live with it rather than attempt any type of revision. The other possibility is that the fat layer in the upper abdominal area is very thick and was cautiously not thinned out by liposuction, leaving the lower abdomen quite flat over the area of skin and fat removal in contrast to the upper abdominal region. This usually occurs in patients with thicker abdominal walls which you do not have.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Bulge after Tummy Tuck

Thank you for the question and pictures.

Your plastic surgeon will be in the best position to give you good advice after direct examination.

The “bulge” in the area you describe is most likely relative muscle laxity or  subcutaneous adipose tissue. This can be differentiated best by physical examination.

I would suggest continued follow-up with your plastic surgeon.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Upper abdominal bulge after a TT

It is possible that you may eventually need some touch up liposuction but overall your result looks good.  You are still early in the healing period given more time these features may resolve.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Is an Upper Abdominal Bulge Normal 3 Months Post-Op Full TT? (photo)

Your posted photos are underexposed so very hard to see any "buldge". Best to seek in person opinions to determine the cause and effect of your issue. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Concern about the appearance of upper abdomen following a tummy tuck

The limited views that you have displayed of your abdomen show a reasonable result with acceptable contours. A frontal view may be helpful in better discerning your issue. There may also be some residual swelling in the area that can take a few more months to fully abate.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Full upper abdomen after tummy tuck

Your abdomen is convex after your tummy tuck, though it just might be related to the shape of the lower chest. Many will have a flare of the rib margin, especially after pregnancy, though you are quite thin and flat across the lower chest giving the illusion of the abdominal bulge. Flat is relative after tummy tuck and based on what we can see, you look pretty well.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

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.