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.