If there is still residual fat, liposuction can be used be improve the hourglass figure of the tummy tuck. 2) Fat: tummy fat is removed with direct removal with a scalpel. Typically, I use about 40 permanent sutures in two layers.
1) Muscle: the rectus abdominis muscles should have been tightened from the sternum to the top of the pubic bone. During a "standard" tummy tuck, three areas should have been addressed. If your tummy tuck was performed correctly, you should not have a pouch.
Your questions are difficult to answer without any pictures or a physical examination. Hello, thank you for your question about a pouch after your tummy tuck or abdominoplasty. Talk to your surgeon, but there is likely nothing further that can be done except to lose 10 pounds or so-and this may still not even give you the "flat" tummy you seek. Unfortunately, sometimes we surgeons are the cause of these expectations if all we show are the "perfect" results with the "flat" after photographs.Yours is the more common result.
Sorry to be the bearer of bad news, but it sounds as if the only problem here was unrealistic expectations. If the amount of skin and fat removed was 3 pounds, this would be a good amount for a woman your size. True, some patients do achieve flat, but usually only if they were flat before surgery (just loose skin and stretched muscles). An imperfect example, I know, but one that illustrates that your "insides" still push outward, no matter how tight your abdomen has been made. No matter how tight you screw the turnbuckles on that trampoline, the bowling ball will still stretch the fabric somewhat, even if you somehow also tightened the fabric by removing some of it. Now put some pressure on that trampoline, like a bowling ball tossed onto its center and being pulled by gravity. Think of your loose stretched (pre-op) abdominal wall as a trampoline (one that is a bit older and well-used i.e., a bit stretched out). (Unless, of course, he "skipped" the muscle repair.) It's the natural stretchiness of your (even surgically-tightened) abdominal wall combined with your own intra-abdominal contents.Īn example might be helpful.
That's just anatomy, and this has nothing to do with your surgeon's skill (or lack thereof), or the technique used. No matter now tightly your surgeon sews the rectus muscle sheaths together, your "insides" (intra-abdominal organs, intestines, mesenteric fat, and omental fat) still had their exact same size, weight, and volume "pushing out" against a tightened, but not rigid and unyielding, abdominal wall and skin. You certainly sound fit and non-obese, but your surgeon still had the same volume and weight of intra-abdominal contents to "contain" within your tightened abdominal wall after removal of excess skin and fat.
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