What do you think has gone wrong with my Tummy Tuck and what can be done to fix it? (photos)

Thank you for your question regarding what went wrong with your tummy tuck and what needs to be done to revise your tummy tuck. Sometimes in surgery, we don't know exactly what happened. Thankfully, we know how to fix things. If you want me to guess what happened with your abdominoplasty, it could be a variety of things. The muscle plication was not tight enough. The muscle plication should be done with a permanent suture and in my opinion, with two layers. The muscle plication is to be done from the sternum to the pelvic bone. The second problem is your surgeon may not have resected enough skin. The amount of skin is completely patient dependent, however, usually, it involves removing skin from just above the pubic region to just above the belly button or umbilicus. A third problem could have been that not enough fat was removed. This is sometimes accomplished either by direct excision or liposuction. Another problem could have been the postoperative healing period. You may have had a seroma or a collection of serous fluid.

Sincerely, Dr. Katzen.
(“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

It appears some of the contour irregularities are from visceral fat (the fat around the organs) which can only be addressed through weight loss. Further skin removal will help the excess you showed in the first two photos. Be sure to ask questions and discuss your concerns. It's important you feel comfortable and confident in your surgical plan.