Six months post op - Advice on upper abdominal swelling. Would this be a failed muscle repair? Do I need a revision? (Photos)

Question

Looking for advice on upper abdominal swelling. I am six months postop after a panniculectomy with muscle repair. I was 160 On the day of surgery, and then now I am also 156 pounds, 5’1 & 31 years old. I stopped compression at around four months, I did start working out again after being Out during surgery, I eat fairly well, and I am currently on Wegovy(Not sure if that means anything, but I’ll mention it) And cannot seem to figure out why I cannot get rid of this bulge that I have. It protrudes out and is very visible, it looks as if I am pregnant, or that I never had surgery at all. Would this be considered a failed muscle repair? My surgeon saw me sometime in April and said that he thought it was just a muscle laxity issue. I do know that I have an umbilical hernia, I’m not sure if that has anything to do with it either. But looking for advice on what to do. I don’t know if I’m holding fluid, constipated, I’m unsure. Thank you so much for your time

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question regarding the fact that you are six months post op from a panniculectomy and have upper abdominal swelling, and whether this could be considered a failed muscle repair and whether you need a revision? Thank you for your pictures and history.  From your pictures, it appears you have distention of the upper anterior abdomen.  This is probably due to years of muscle stretch from obesity.  Work-up should include an abdominal CT scan or MRI to examine your peritoneal cavity.  Work-up may show that you still have visceral fat.  If you have persistent visceral fat, you need to lose more weight.  Work-up may show weakened rectus abdominis muscle.   It could be that the muscle plication can only do so much.  If the muscle is still weak or distended, you and your chosen plastic surgeon may want to consider application of surgical mesh above the rectus muscle to flatten to abdominal wall. I hope that I have answered your question regarding the fact that you are six months post op from a panniculectomy and have upper abdominal swelling, and whether this could be considered a failed muscle repair, and whether you need a revision.  Most plastic surgeons offer free virtual or in-office physical consultations.  Therefore, explore what other plastic surgeons have to say.  If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon. Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks.  Do your research.   If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and  member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Six months post op - Advice on upper abdominal swelling. Would this be a failed muscle repair? Do I need a revision? (Photos)

Answers (1)

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