Dr. Pane evaluates a patient whose tummy tuck didn’t deliver the results she’d hoped for.

The Question

Liposuction and abdominoplasty, or tummy tuck, procedures send a lot of questions our way. One great example is a question we received from Facebook. The patient asks, “I had a tummy tuck with a muscle repair done a couple of years ago. After healing, it left a bulge at the bottom of my abdomen. My doctor at the time suggested exercise. I tried that and it didn’t work. Will liposuction be enough to correct this, or do I need to consider a tummy tuck revision?”

The Case

Dr. Pane reviewed the pictures the patient included with her question. He noted the patient does have some bulging around the lower abdomen, but does not appear to have a great deal of loose skin visible in the photos. However, as always, photographs are not always fully indicative of the issue, nor can they conclusively establish what the best corrective procedure may be.

Dr. Pane’s Answer

In this case, where there is roundness of the abdomen and scarring from the original tummy tuck, the first thing to look at is skin quality and tightness or laxity. Based on the appearance of the pictures, the skin looks to be in reasonably good condition, without a lot of laxity. The problem is, pictures are never the best way to determine overall skin quality, and it’s hard to be certain in this case what is going simply from looking at the surface.

One major question is whether, and how, the muscle tightening was accomplished during the original procedure. Another is whether the patient has gained and lost weight since the original tummy tuck. If the bulge is not due to a great deal of fat surrounding the organs and it’s all gathered at the surface, a full session of liposuction may be all that’s required. However, if there is a lot of fat around the internal organs or an in-person examination revealed loose or damaged skin in the area, a tummy tuck revision with abdominal muscle tightening and a revision of the belly button area to help ameliorate the scarring may be a better option. Only an in-person clinical evaluation and complete review of the patient’s medical history can really determine which is the better option.

There are a number of reasons patients might experience abdominal bulging after a tummy tuck procedure. Weight gain and loss may impact the overall results over time, as can wearing compression garments improperly or for a duration other than recommended by the surgeon. Additionally, when liposuction is performed, fat deposits are removed, but it is virtually impossible to element all the subcutaneous fat in a given area. This can result in weight gain in configurations the patient may not expect or that would not be considered “normal” under other circumstances.

One of the major drawbacks of performing revision procedures is the risk of complications. Any time an area must be redone for any reason, this can lead to unexpected and problematic issues for the patient. To get the best possible results from a revision, aftercare and postoperative supervision become even more important than usual. This includes following all instructions from clinical and surgical staff, keeping in contact with any unexpected or unusual developments and rigorously adhering to all prohibitions, limitations and warnings concerning activity, environment, habitual factors and other common causes of complications.

Another key consideration is to make sure you are comfortable with the experience of the surgeon you choose. Some surgeons focus on only certain types of procedures or certain ways of performing them, which may not be ideal for your body type or the intended outcome. This does not mean they are necessarily bad, incapable or incompetent, but the fewer limitations a surgeon has on the services they offer and the more experience they can demonstrate with a number of different procedures, the more likely it is that you’ll be satisfied with the results you’ve received.

At Atlantic Coast Aesthetics, we believe it is important to listen carefully to our patients and educate them to the best of our ability and knowledge. That’s why we make it very easy to reach us! Simply follow us on Facebook and Twitter, call us at (561) 422-4116 or email us through our main website at https://acplasticsurg.com. Your question may even become the topic of our next Ask Dr. Pane segment, letting us educate others who share your interests, questions and concerns. Remember, at ACA, we believe the only bad question is the one you don’t ask!