Round Waist 2 Years Post- Tummy Tuck - Why?

I agree with my colleagues....if you see a change from before, then it is either fullness from weight gain, or the muscles have stretched out again.  It would be easier to tell if you had a lateral photograph (picture from the side).  It is also possible that the "plication" (tightening procedure of the muscle fascia) that is typically done with the tummy tuck was either not done very tight, or the sutures may have pulled through.  Some surgeons do a suture technique that can be more prone to this than others; sometimes it is simply the tissues are fragile and thin.  Either way I would revisit a board certified plastic surgeon.  If it is from weight gain, the two solutions are weight loss to shrink intra-abdominal fat and lipo maybe to contour the extra-abdominal fat, and reopening the incision to re "plicate" or tighten the muscles again. 

Sincerely,

James F. Boynton, M.D., F.A.C.S.

It is impossible to give you specific advice without examining you and/or reviewing before and after pictures.  If you have gained weight, then it is possible that this explains your situation.  Additionally, in your picture, your panties are constricting your lower waist which exaggerates the look of your upper waist.  You may want to consider some liposuction of your flanks to improve the contour of that area.

 

Good Luck.

A round waist two years after a tummy tuck can be one of a two things - either you're accumating fat in the area or your abdominal tissues have "weakened."  What does this mean and how can you tell?

If you've accumated fat, you've put it either above or below the abdominal muscle.  Now since you've already had a tummy tuck, most of the fat above the muscle has been surgicall altered.  Even though you've only gained a couple of kilos, you've probably put it below the muscles (inside the abdomen).  This pushes the abdominal wall outward and creates a rounded look.  If you can't "pinch" the extra fat that concerns you, it's probably intra-abdominal.  It that's the case, only you can change your contour (diet and excercise).

Part of most tummy tucks is tightening the abdominal muscles, usually by running a stitch up the middle of the abdominal wall and bringing the "rectus" muscles together.  Rounding of the abdominal wall can be related to either failure of this stitch over time or a thinning of the lateral wall tissues in response to "over-tightening" in the initial surgery.

Exam is crucial.  I would suggest following up with a board certified plastic surgeon near you who can examine you. 

Your situation is rather common.

The IDEAL hourglass figure has a Waist to Hip ratio of 0.7. During your tummy tuck the waist was narrowed thereby reducing the numerator of this relation. If no liposuction of the hips is done at the same time, the denominator (Hip width) stays the same but appears larger. Any weight gain will be highly visible in the hips which is exactly what your photographs display (with the underwear falling into the depression below the hip fat prominence). To improve this appearance, you need to lose the weight or have liposuction.

Dr. Peter Aldea

Ashli,

It is highly likely that your 2kg weight gain has gone straight to your waistline.  Two kgs is a fairly significant amount of weight as a percentage of your body weight, which looks to be low in the photo.  Try dieting off the 2kg and see what happens.  If that doesn't do it, then go back to your surgeon for an evaluation.  Good luck!