This response was dictated using Word recognition. My apologies in advance for any grammatical errors. The most common reason patients complain of abdominal bulging after a full tummy tuck is due to excess visceral fat. This can often be seen on both before, and after pictures. Individuals who have excess visceral fat are not ideal candidates for tummy tuck surgery unless they lose weight first. To break things down there are four tissue variables that determine what the abdomen looks like. To determine the best treatment or somebody’s candidacy for surgery we need to assess which of these tissue variables is causing the primary problem, which one is secondary, tertiary, etc. The four tissue variables that determine what the abdomen looks like are the following. 1) abdominal skin, laxity typically due to previous or significant weight loss(best treated with full tummy tuck) 2) excess subcutaneous fat.(best treated with Liposuction.) 3) muscle separation from previous pregnancies.(best treated with full tummy tuck.) 4) excess visceral or intra-abdominal fat.(can only be treated with weight loss.) At tummy truck primarily treats, abdominal skin, laxity, and muscle separation. For that reason the ideal candidate for a tummy tuck should have only excess skin laxity and or muscle separation. Individuals who have excess subcutaneous fat or excess visceral fat are going to be lesser candidates for this procedure. individuals who have excess visceral fat, are going to get increased in abdominal pressure if the abdominal space is refused in size with muscle tightening from a tummy tuck. The increased intra abdominal pressure will press against the abdominal wall and against the diaphragm, making it feel difficult to take a deep breath and like the abdomen is constantly firm, tight and hard. Quality assessment for tummy tuck surgery should differentiate between the above for tissue variables, which determines each unique patients in individual candidacy for the procedure, and what the results are going to be like. Plastic surgeons who don’t acknowledge or recognize individuals who have access digital fat and don’t explain. This variable to patience are going to have patience who typically come back with problems or concerns. These patients should be told they need to lose weight in order to be a good candidates. The good news is that you can lose weight before or after the procedure and get the same results. I don’t know what your results look like because you didn’t include pictures. I suggest always including proper before and after pictures whenever requesting and assessment regarding the outcome of any plastic surgery procedure. Regardless of what your abdomen looks like or what your weight is I suggest dropping 5 pounds and reassessing. if possible, loose another 5 pounds, then reassess, take pictures and make notes regarding how your abdomen feels. You’ll eventually get an understanding of what weight you need to be at to feel comfortable. This will most likely also reflect on your physical appearance. Take pictures at each weight loss interval to see how this affects your results and the sensation of tightness and fullness. There is no surgical solution and weight loss is most likely the only way to get relief from what is most likely excess visceral fat which now has created, increased in abdominal pressure due to muscle tightening from a full tummy tuck. I am without question making a fair amount of assumptions with my statements. I’ve been doing this long enough to recognize patterns when I see them. Consider reposting with proper before and after pictures to get quality assessment. Alternatively, schedule in person second opinion consultations with other providers in your community. For second opinion consultations always come prepared to bring me with you and complete set of proper before and after pictures and a copy of your upper report. These are part of your medical record that you can request at any time from your current providers office. Weight loss can be a struggle, but my instinct tells me that you would benefit greatly even from a small amount. Best, Mats Hagstrom, MD