I had a patient inquiry about her upper abdominal bulge after a mini tummy tuck. She was only a week out from surgery with another doctor, so she needs to wait to evaluate what is real and what is post surgery changes. But the better question is why?
Why would you get a bulge in your upper belly? And if it is real, what is the fix?
Mini tummy tucks are alluring. As I have said before, everything sounds better when it is mini. Mini M&Ms must not have as many calories. A mini skirt? Oh so alluring. And that mini car? Adorable!
Mini isn’t always better. Pregnancy affects the length of the belly muscles, from your rib cage to your pubic area. I don’t care if you carried high, or carried low, or carried to one side or the other. There will be differences, and when I tighten your muscles I can usually see how you carried. But you will be loosened to some degree throughout the length of your muscles.
I don’t tend to tighten the muscles when I do a mini tummy tuck. If I do tighten the muscles, I do so moderately. In English that means I am not going to tighten you so you can bounce a quarter off your belly. Why not? Trust me, I’d love to have all women after kids have rock hard abs. Heaven knows we deserve them. The issue is the belly button. When doing a limited incision (this includes the endoscopic approach) you can’t get great exposure of the muscles in the upper belly.
To retighten the muscles and let the skin redrape, you need to repair the length of the muscle, from your pubic area to your ribcage. You need big strong suture. I always do a two layer repair. My California girl patients are athletic (keeping them from exercising is tough). If you are active, you will be hard on my repair. Suture and scar are never as strong as your original tissue. So the muscle tightening is important.
You may think, “I carried low.” “My upper belly doesn’t look so bad.” “Why would I need to tighten the upper belly?” If you tighten the muscle only below the belly button, I expect you will bulge in the upper belly. If you tighten both above and below the belly button, but tighten the muscle below the belly button tighter, you will bulge. You must tighten them so there is even tension when you are done.
At one week, you can’t tell what is what. So you should wait. But if your upper belly is truly bulging, the fix? You may need a full tummy tuck to get your desired result.