The Question
One of the most commonly performed, and yet most misunderstood and misrepresented, cosmetic surgery procedures is the tummy tuck. Often done for men and women who have lost a lot of weight through bariatric surgery, diet and exercise or childbearing and birth, this procedure is designed and intended to eliminate loose skin around the midsection and create a tighter, firmer-looking abdomen. However, this procedure must be approached with realistic expectations from both the provider and patient sides, as the focus of this week’s Ask Dr. Pane segment shows.
The viewer, from our YouTube audience, asks, “Feeling bloated after a tummy tuck—what should I do? [At] 6 weeks, I feel super bloated and my lower abdomen looks like it used to before the tummy tuck and muscle repair and so I have to hold in myself like I use to. But the doctor is telling me that is because of what I been eating. Can I request them to check with an ultrasound now to see if everything is ok with the muscle repair or what should I do? [This] is my first plastic surgery in my life.”
The Case
The viewer did not provide any other medical history or before and after photos, so Dr. Pane stresses this answer is only a “best guess” based on experience and the patient’s description of the current situation. This should not be taken as a substitute for an in-person consultation, nor should it be considered an indictment of the surgeon who originally performed the procedure.
The Answer
Tummy tuck can do a lot to help restore a more youthful and streamlined appearance to the abdomen. However, setting realistic expectations is very important. Not everyone comes out of a tummy tuck with a perfectly flat, “Cameron Diaz” belly. In a few lucky cases, yes, this can happen, but many patients who undergo tummy tucks also have excess abdominal fat and/or loose abdominal walls, where the muscles tend to sag and bulge down and outward a bit. Even with a tummy tuck, liposuction to remove the subcutaneous fat and muscle tightening, there are limits to how much a loose abdominal wall can be corrected and the patient may still have a bit of bulging once the healing phase of the procedure has resolved.
Generally, a cosmetic surgeon is unlikely to order an ultrasound to check the area unless the patient’s medical history or other factors seem to indicate its necessity. However, this does not mean the patient shouldn’t consider speaking to their OB-GYN or general practitioner to rule out potential problems such as uterine fibroids or other pelvic issues, which sometimes can and do present similarly to what the patient describes. However, if the overriding symptoms are simply abnormal bloating and swelling of the abdomen without any other change in diet or activity, it is likely the procedure and/or healing from same are the root cause of the symptoms.
Because of the lack of further information or comparison photos to work with, Dr. Pane speculates that what the patient is experiencing is most likely a combination of postoperative swelling and the fact the patient has a loose abdominal wall and/or intra-abdominal fat which is now more visible because of the tummy tuck. If this is the case, complete flatness shouldn’t be expected and hopefully wasn’t promised to the patient in the first place. Without knowing exactly how the procedure was done, it is hard to be more specific than that. The postoperative swelling should be beginning to subside by now, but the patient probably shouldn’t expect complete abdominal flatness. If necessary, the patient should certainly seek out other opinions and eliminate other causes, but in Dr. Pane’s opinion, the symptoms the patient reports are tangentially related to the actual procedure, at most.
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If you have a question related to any facet of cosmetic surgery, Dr. Pane welcomes the chance to discuss your interests and concerns. Simply follow us on Twitter, Instagram, Facebook, LinkedIn and YouTube; email us through our Contact page; or call us at (561) 422-4116. Your question may even be selected as the focus of a forthcoming Ask Dr. Pane segment, allowing us to inform and educate you and others who share your question while giving you the honest information you need to make sound choices about your cosmetic surgery options and care. Remember, at ACA we believe the only bad question is the one you don’t ask!