Is this dent normal? Do I need a tummy tuck revision? (Photo)

It's difficult to determine from your photos what may be causing your concern. It is unlikely that a failed muscle repair would occur and cause a dent. I encourage you to visit with your surgeon for an evaluation.

Dear Exquisite645710,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The dent may be from thinning the fat a little more in that area, or you may have been naturally somewhat thin in that area, but an examination is needed to be sure. More fat could be removed from the sides with liposuction. Please discuss this with your surgeon.

Simple fix via macro fat grafting of 100cc's under local anesthesia. Fee $3,000 ranges. Or maybe your chosen surgeon would revise area fr limited fees?

The pictures don’t really show the problem well and makes it very hard to make an assessment in regards to what could be causing it.

Contour irregularities on the upper abdomen after this procedure can be related to the shape of the muscle wall, liposuction done during the procedure, the extent of undermining adjacent areas causing the skin to drape with contour irregularities and possibly related to muscle tightening though unlikely.

To help differentiate if it’s skin fat or muscle while you can try the following.

Put the skin under tension above the area of concern by pulling up on your breast and the skin in the midline to put the upper abdomen skin under tension.

When the skin is pulled does the contour improve?
The next step is to assess the thickness of your fat layer.

This is best done with the skin under gentle tension again pulling up with one hand above the area of concern then take your finger tip and gently push in against the skin until you feel the muscle wall. Do this in different areas and get used to assessing the thickness of the fat layer. Now go back-and-forth and do it over the area with the inventation and the adjacent areas and ask if the fat thickness is the same or different?

You can use the same technique to assess the muscle wall. When assessing the muscle wall it’s easier if you do it with both hands using one finger on each hand.

Gently press against the skin until you feel the underlying muscle wall then move with those fingers up and down to see if the muscle wall feels flat and even or if it protrudes more in some areas or feels sunken in some areas. This can be done either laying on your back or in a standing position.

It’s not uncommon for plastic surgeons to do Liposuction of the abdominal wall as part of a tummy tuck to improve the results. It’s especially common for plastic surgeons to try to create a defined midline contour line met making the linea alba.

If the contour irregularity is related to the extent of undermining or a lack of sufficient undermining up on to the chest wall then this is going to be the most difficult to assess and correct.

Obviously following up with the surgeon who did your procedure is the first step. If that doesn’t give you the answers you’re looking for then you probably need to get an in person second opinion by having a second opinion consultation.

When scheduling second opinion consultations I recommend patients come prepared by bringing before and after pictures and a copy of their operative report. These are all available from your surgeon as part of your medical records which you can request and they will forward to you.

You also need to ask yourself if this bothers you enough to have surgery to improve it.
Good luck,

Mats Hagstrom MD