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Why do I have a muffin top after tummy tuck?

Thinned out muscles and their lining causes this muffin top deformity in some patients. This occurs following muscle tightening if the increased tension makes the muscle and lining stretch out again. The medical terminology for thinned out muscles is muscle attenuation.

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How To Avoid a Muffin Top After Tummy Tuck

A “muffin top” refers to the protuberance of the upper abdomen which results in a protrusion (bulging outward) of the upper abdomen and concave (curving inward) lower abdomen. This contrasts to the more desirable “ideal” abdominal shape characterized by a concave upper abdomen and gentle convexity of the lower abdomen. Below is an example of a patient who underwent a tummy tuck with muscle repair by another surgeon. As you can see in the picture, her surgery resulted in a less than desirable “muffin top” appearance.

What Causes This Complication?

The question that patients consulting me for a revision tummy tuck routinely ask me is why did this happen?

To understand how this complication occurs, we have to review the anatomy and surgical maneuvers used during tummy tuck surgery. After lifting the skin of the muscles, surgeons repair them by plicating the muscles in the middle like a corset. Plicating just translates to “tightening”. This vertical tightening of the muscles is performed both above and below the belly button. If one tightens the muscles above the belly button less than the muscles below, it can create a muffin top. Optimally, your surgeon should tighten the muscles above the belly button just slightly more than the muscles below the belly button in order to provide you the desirable concave upper abdomen and slightly convex lower abdomen. Another possible cause of the muffin top after a tummy tuck can occur despite appropriately placed tension of the repaired muscles. Thinned out muscles and their lining causes this muffin top deformity in some patients. This occurs following muscle tightening if the increased tension makes the muscle and lining stretch out again. The medical terminology for thinned out muscles is muscle attenuation. Unfortunately, it is not possible to tell if your muscle repair will hold until after your surgery.

Tummy Tuck Revision to Repair a “Muffin Top”

We can fix a “muffin top” in two ways. If improper muscle tightening by the previous surgeon is the cause, then a revision tummy tuck will require resetting the proper tension so that the upper muscles are tightened slightly more than the bottom muscles. If the muffin top resulted from muscle attenuation, then you will require a Tri-Modality repair, which will not only tighten/repair but also reinforce your entire abdominal musculature, thereby eliminating the potential for further muscle stretch.

Are You Considering A Revision Tummy Tuck?

Are you unhappy with your results or struggling with a “muffin top” or other complications following a tummy tuck surgery? Contact Dr. Mowlavi for a free consultation to see how you can improve your results and achieve a flat, beautiful stomach. For your convenience, we have offices in Newport and Laguna Beach, CA.

SEE ALSO: The Top Five Tummy Tuck Success Factors

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Why do I still have a pooch after tummy tuck?

Answer: Pooch after tummy tuck Fullness in the lower abdomen can be related to the intra-abdominal organs. This may be related to bloating of the bowels for example and not be related to swelling of the skin or tissues. Again, give it some more time and speak with your surgeon about your concerns.

The photos are very hard to evaluate. It is normal to have some redundancy in the lower abdomen, as that is what allows us to straighten up and bend at the waist; if we were rigid in that area, we would not be able to flex at the waist. Accordingly, there is some redundant skin that is normal to have even AFTER having had surgery. However, you could also have swelling related to the procedure, residual fluid buildup (seroma), or intraabdominal (visceral) fat that became more noticeable to you after the excess apron of abdominal skin was removed. At this early postoperative juncture, you should be patient and follow the surgeon's instructions including garment use. Talk to the surgeon to see if additional maneuvers like lymphatic massage might be recommended (for instance, if you also had liposuction). Above all, be patient until you are at least 6 months out and continue to maintain an appropriate diet and activity regimen approved by your surgeon to allow your result to take shape.

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