Dear SM East Bay,
From what you have described, it does not sound like you have a pseudo-bursa. The roundness of abdominal shape may be caused by loose abdominal wall or excess fat or a combination of the two. Fat can also be under the skin or deep to the abdominal wall. The first layer can be liposuctioned while the second, deeper layer usually cannot be addressed. A CT scan can certainly shed light on pseudo-bursa, fat layers, and abdominal wall but so can an in depth physical examination. I would simply describe and prioritize how you would like your abdomen and waist to look and have a discussion with your plastic surgeon about what is possible and what may not be possible. Abdominal wall tightening would require a full tummy tuck revision. In doing so pseudo-bursa evaluation and removal can be performed if present. I hope this helps.
All the best,
Dr. Remus Repta
SM EAST BAY said…
Dr. Repta
I am just at 5 months post-op from my Tummy tuck +. I did a lot in my surgery (Nipple lift-augmentation (smallest size available), tummy tuck along with flank lipo & lipo of my outer thighs.). My Dr. is Highly rated & loved. He has his own surgical center – attached to a hospital. Sanitation procedures before surgery where intense (washed with wash they provided before surgery, no products, was given a iodine sponging from head to toe and had to get myself onto the thickly lined table while touching Nothing but the blue sheeting. I did everything I was told – walking, binders, etc., I seemed to be healing well, body looked good except for the bruising – I was out of it and in lots of pain (could never take the meds). My tummy, belly button & breast incisions healed great, but my lipo seemed to heal and then at about 2 months they got red and pussy again. Had two cycles of Keflex (1 before/just after surgery), did not work so was changed to Ciprofloxacin by plastic surgeon as well as my primary care (he suggested I get a culture). It did take care of the pussing and they incisions did finally close and are ‘healed’. But sometimes they still itch, and they have a thickness under them (like an absess feels). I never had a fever, but they still will get itchy and reddish and warm. Ironic I was writing this mainly because of my belly issue, but this issue concerns me too, after reading some of this post, because my belly at that point, seemed swollen. I pointed it out to the Dr., and he said it is most likely some fat he could not get to- and I could lipo later – he did ask about my weight gain, but I have not gained any weight – my belly extends out, the belly incision line is quite a bit in, and if I tuck really tight my belly looks more flat and much more appealing to me – I hate to say it, because of his reputation and ethics, but it seems like he didn’t tighten the muscle enough or something. I mean at the 2-5 month, could I have a loosening of the muscles? Can I cure this with exercise? (I have a back injury so that is difficult). When I read your post, I saw that sometimes Pseudobursa can have oosing? But my oosing was not in my tummy, but in my lipo incisions on my high hips just under the tummy tuck incision. Another point worth mentioning, is that my tummy is still very very tight, my flanks JUST woke up a few weeks ago (which I was told could happen), and my tummy is still numb down the center, I can only feel INSIDE my belly button. But my incision and center tummy are still very very tight, and very sore. The doctor has said this can be very normal. I only have 7 months of corrective rights under our contract, and I have a wedding in 9 months. Would you please provide some insight into my situation. I do not like my plump (it does push, it is not tight) tummy, or the infection connection to it. Just want to be sure I come to him with questions. I actually have my 3 month appointment in a couple days. I appreciate any onsite you can provide. Thank you!