4 1/2 Weeks Post Op Drain Free Tummy Tuck. Will Skin Get Tighter ?

Everyone gets a roll of "loose" skin when they sit, even children! If your belly was flat when sitting, then the skin would split (or at least stretch out) when you stand, leaving you with loose, stretched skin the next time you sit or bend over. This is what allows your torso flexibility, just as the loose wrinkled skin of our knees and elbows does when those extremities are straight!

The truth is that your swelling will diminish as time goes by, your scars will soften and fade, and you will have a good result.

Since you have a vertical scar above your pubic area, it is evident your surgeon felt s/he could not remove all of the skin between your pubis and belly button. This is a judgement call made by all of us at the time of surgery. Perhaps a tighter closure might have been possible by more skin removal, but that also might have required more dissection superiorly to free up more skin and allow more stretch and mobility. That in turn might have required a drain.

Some patients are more impressed by "drain-less" surgery than by more aggressive freeing-up of the skin and more skin removal. But this is for you and your surgeon to discuss now, and for you to have considered prior to choosing your surgeon.

At this point I would suggest waiting 6 months or more for everything to soften and settle, after which additional skin can be removed in another operation, if that is your request. For examples of my tummy tuck patients in various stages of scar maturation, click on the web reference link below. Best wishes! Dr. Tholen

At 4 1/2 weeks post-op you look as expected.  There is swelling that takes a couple months resolve, and the final result takes six months.  There is always a lot of swelling just at and above the suture line because lymphatic drainage has to reform  through the scar. The skin does not actually get "tighter" but the contour improves as the swelling goes down.

At 4 and a half weeks postop, it is normal to have some residual swelling, especially in the most dependent area right above the incision line. Swelling in this area takes the most time to resolve and will continue to improve over the next several months. Best of luck in your recovery!
Emile N. Brown, M.D.
Johns Hopkins & Harvard Trained Plastic Surgeon

The skin may tighten a little bit as your wounds heal, but probably not enough for you to notice. If you are only 4.5 weeks postop, I would not evaluate the appearance of your abdomen quite yet. It takes about 4-6 months for all the swelling to be resolved.
Phillip Dauwe, MD

Swelling can last up to 6 months after any surgical procedure, so it is not common for you to be experiencing swelling at only 4 weeks post op. The incision can swell the most, especially towards the end of the day. (swelling travels downward.) Massaging the lower abdomen in a circular motion a few times a day and help break up some of that swelling and hardness you may be experiencing. Over time, the swelling will resolve and the scars with lighten and fade. Some people may experience some skin retraction following liposuction if that was performed during your procedure as well.  It is also important to utilize an abdominal binder for 4-6 weeks after a Tummy Tuck. Compression is key for swelling. Be sure to follow up with a physician to evaluate you and make sure you are healing adequately.Best of luck ! 

You will have swelling in your abdomen for up to 6 months after the procedure.  You should wait on any final evaluation of your results until you are fully healed.  The drain free part of the procedure won't have any effect on the tightness or lack there of.

It is still early into your healing. Healing after a  #tummy tuck will require time. Your abdomen will feel tight for a month or longer. If you have had a muscle repair as well (the usual case), you will feel the most tightness down the center of your tummy where the doctor has actually repaired your muscles. The purpose of the post-procedure #garment is to provide some gentle #support and to reduce swelling following a #TummyTuck or #Abdominoplasty. If it feels too tight or causes pain, take it off. Patients wear the #elastic garment for several weeks after surgery, as directed by their doctor. Some choose to wear it longer for several months for comfort.The #healing process make take at least 3-4 months until you see your final results. I suggest you contact your surgeon or their medical staff and further inquire. At any time, you have any concerns about your healing or recovery, it's best to contact your plastic surgeon  sooner than later,  to prevent any possible infections or #healing complications.

At only 4.5 weeks postop from a drainless tummy tuck, you are still relatively early in your recovery with some abdominal swelling remaining.  I tell my patients to hold off on evaluating their tummy tuck results until at least 3 months postop when the majority of the swelling has resolved.  There is typically still a small amount swelling at that point that will completely resolve after 6 months to 1 year.  The skin will continue to shrink as the swelling resolves. 
An additional consideration is whether you had plication of separated abdominal muscles.  Abdominal muscle separation (diastasis recti) can cause bulging, which would still be present after surgery if this was not repaired.  Another question is whether liposuction was performed at the same time as the tummy tuck.  Most patients have both loose skin (addressed with tummy tuck) and excess fatty tissue (addressed with liposuction), so these procedures are often combined to achieved the most optimal abdominal contour.  Finally, everyone has some bulging of abdominal tissue when they sit, so that should be viewed as normal.  I would recommend following up with your plastic surgeon to express your concerns and allow for a thorough physical examination.  Good commination between patient and surgeon is very important both before and after surgery.  Best of luck in your recovery!
Ziyad Hammoudeh, MD@drhammoudehMayo Clinic-trained, Double Board-Certified Plastic SurgeonDiplomate, American Board of Plastic SurgeryDiplomate, American Board of Surgery

Thank you for your question.
Swellong post abdominoplasty will gradually go down, you should wait 4-6 months to see the final result. The roll you feel when you sit is absolutely normal and everyone (even really thin person) feel il when they bend or sit.
Please consult your surgeon for your regular follow-up. You seem to have a great result!

Best Wishes
Dr Genevieve FCaron, Board Certified Plastic Surgeon
Montreal.Canada

It is normal to have some swelling after Drainless tummy tuck, especially in the lower abdomen and pubic region where edema fluid within the tissues can tend to linger until the lymphatic channels re-establish themselves, and can then clear the fluid.  Use of a binder is invaluable in minimizing edema after abdominoplasty and should be continued for at least 4 weeks.  An important tip is that the binder should not be worn tightly, since that could lead to compromised blood flow and wound healing problems.  The chance of the swelling being caused by a fluid collection is minimal if the procedure is performed correctly.I hope this answers your question.  Good luck!