Do I need a revision to correct bulge and waist shape after tummy tuck with muscle repair? (photos)

Question

I had a tummy tuck with muscle repair. My doctor said he could not do lipo because it would look lumpy. I have ended up with a lower tummy bulge that I am not sure if it's fat that has settled there or maybe my muscle repair was not done tight enough. I am also not happy with my shape as my waist is wider now than before the procedure. What are my options here? Do i need a full revision?

J. Timothy Katzen, MD, FACS · Answer

Hello parisprincess,

Thank you for your question regarding the bulge and waist shape after your tummy tuck with muscle repair.

Assessing Your Current Results:

From examining your photos, it does not look like you need a full revision of your tummy tuck. The bulge you are experiencing and the wider waist may be due to residual fat or the natural settling of tissue post-surgery.

Options for Improving Contour:

Liposuction:

Liposuction can be a great option to further contour your abdomen and flanks. It can help remove any residual fat and create a more defined waistline. Liposuction can be performed safely without causing lumpiness if done by an experienced plastic surgeon.

Muscle Repair:

If you are concerned about the muscle repair not being tight enough, it is essential to consult with your surgeon to ensure the repair was done correctly. However, from your description and photos, it seems more likely that the issue is related to fat distribution rather than muscle laxity.
Next Steps:

Consultation with Your Surgeon:

Schedule a follow-up consultation with your surgeon to discuss your concerns. They can evaluate the results and determine if liposuction or any other procedure would be beneficial.
Customized Treatment Plan:

Work with your surgeon to develop a customized treatment plan that addresses your specific concerns and desired outcomes.
Conclusion:

Based on your photos and description, it does not appear that you need a full revision. Liposuction could help contour your abdomen and flanks, giving you the shape and definition you desire. Consult with your surgeon to explore this option further and ensure it aligns with your goals.

Good luck, and I hope I’ve answered your question regarding your tummy tuck results and options for improving contour.

Sincerely,

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

Daniel Barrett, MD · Answer

Dear parisprincess,
I understand your concern. Based on your photos, it looks like you won't need revision tummy tuck to correct it. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

It is unlikely you were waist size changed much. Sometimes after a tummy tuck, clothes sit differently. Much of the waist contour is determined by the underlying bone. From your photographs, it seems that you may be a candidate for tightening the muscles. You should consider going back to your plastic surgeon and discuss the possibility of additional tightening.

Guler Gamze Eren, MD · Answer

Thank you for your question. You have a pretty good result with TT. Liposuction can be done if you have on love handles and it will lower the curve of the waist. You must do work out to strengthen your abdominal muscles to reduce the bulge.

Connie Hiers, MD, FACS · Answer

An examination is needed to see if the bulging is above the muscle or below the muscle and how tight the muscle now is. Some have internal fullness, often from food allergies, that surgery will not change.

Camille Cash, MD · Answer

It's difficult to comment on your results without seeing your before photos.  It does appear you may have some contour improvement with liposuction to address subcutaneous fat.  In order to further tighten the abdominal wall a revision would be needed.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment on the outcome of any plastic surgery procedure, we need accurate pictures.
We need a proper set of before and after pictures.
If you don’t have those, then ask your provider to forward the pictures they took.
Taking your own selfie, a mirror is less than ideal.
Without knowing what you look like before the procedure, it’s difficult to tell you why your outcome looks the way it does.
GenerallyWithout knowing what you look like before the procedure, it’s difficult to tell you why you’re outcome looks the way it does.
Generally speaking, there are four tissue variables that determine what the abdomen looks like.
This is true whether someone has had previous surgery or not.
The four variables that determine what the belly looks like are the following.
1) Abdominal skin laxity typically due to previous pregnancy.2) Excess subcutaneous fat.
3) Muscle separation from previous pregnancies.
4) Excess visceral or intra-abdominal fat.
it doesn’t look like you have a thick layers of subcutaneous fat.
I also don’t think you have an issue with visceral fat.
Whether muscle tightening was done insufficiently or not, would require an examination or at least comparing your before and after pictures.
During an examination, it’s fairly easy and straightforward to differentiate between each of the above for variables.
If the abdominal wall itself is bulging, then that typically is due to either excess visceral, fat or muscle separation.
 excess subcutaneous fat can also cause some bulging.
Liposuction can deliver spectacular outcomes without contour irregularities, but it needs to be done by someone who has the skill to do Liposuction well. If your doctor didn’t have good Liposuction skills, then you you were both wise to not have Liposuction done during your procedure.
I suggest scheduling a few in person second opinion consultations with other plastic surgeons in your community.
For second opinion consultations come prepared to period.
This means having a complete set of proper before and after pictures and a copy of your operative report.
These are all part of your medical record and you can obtain those by asking your current provider.
Differentiating between the four variables isn’t rocket science and most plastic surgeons should be able to help you with this.
Liposuction of your love handles If done correctly would complement and improve your outcome significantly.
Finding the plastic surgeons who are exceptional at Liposuction is not easy or straightforward, and takes a bit of effort.Liposuction can’t leave people disfigured if done by providers who lack sufficient skill and experience.
While this is true for all procedures. It is especially true for Liposuction.
Best,
Mats Hagstrom MD

Luis Ramon Sang Vargas, MD - Account Suspended · Answer

You possibly need a liposuction procedure to flatten your belly. And see the possibility to have some technology done to ensure you skin retracts after the procedure.

Do I need a revision to correct bulge and waist shape after tummy tuck with muscle repair? (photos)

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