I am 4.5 months post op from full TT. 6 wks post op I became ill w/ violent cough, sneezing. I was very flat for 6 wks po..then a bulge began. PS says it's fat and he wants to lipo. I explained that does not make sense b/c it was flat before and also it's in the place were I feel so much strain when I sneeze/cough..and I have a hard bulge..bulge flattens some with rest. He said he did 1 layer of sutures. I suspect a muscle repair issue. Could muscle be swollen, but repair intact?
Bulge Above Belly Button After Tummy Tuck...What is It?
Doctor Answers 7
Upper abdominal bulge after abdominoplasty. Possible causes
It is doubtful that you've suddenly developed fat in the area above your belly button. The swelling is either a small seroma (small fluid collection) or a slight separation of the abdominal wall repair. An ultrasound would diagnose the seroma . Lying flat and lifting your head would reveal the separation if that is the case. A separation would require reoperation and reclosure, while seroma would require aspiration to remove it.
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You probably busted your sutures
A bulge that occurs in the upper abdomen following a coughing spell...six weeks after a tummy tuck, is most likely a rupture of the suture plication. This can repaired, but requires that the entire flap be re-elevated.
Bulge after tummy tuck.
The bulge above the belly button which occurs following illness with violent coughing at six weeks is most likely a separation of the repair. The muscles don't really "swell" from a diastasis repair. Swelling should improve over time, not get worse. Also fat should not simply "appear." A straight leg raise while lifting your head off the exam table will diagnose a separation quite easily. Unfortunately, repair of this requires an operation although it may be performed via the belly button in some cases.
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Upper bulge after tummy tuck
It is possible that with the coughing spell early in the post op period, you may have popped some sutures with the facia repair. The muscle is not swollen at this point and it is only one of two things. Failed facia repair due to the coughing issue or fat. Your plastic surgeon knows the difference. you can do a sit up and see if the bulge occurs.
"Bulge" Above Belly Button after Tummy Tuck?
Thank you for the question.
You provide a very good clear description of your situation post operatively. I think it will be very important to make an accurate diagnosis before any intervention is undertaken. Abdominal wall laxity (for example with localized disruption of the muscle plication repair) should be ruled out before liposuctioning is done.
The muscle laxity can be diagnosed on physical examination; for example, by having you lie supine and raising your head up, muscle laxity may become more obvious. This may also be seen when you're standing and go into the “diving” position.
If you still have concerns about your plastic surgeon's “diagnosis”, seeking in person consultation with another well experienced board-certified plastic surgeon may be helpful.
Several things can cause sudden bulge after tummy tuck
A sudden bulge following a cough or sneeze soon after tummy tuck surgery can be from a few things. One of them is a tear in the muscle repair., but another possibility may be from a small amount of bleeding that can occur where a suture pulled with the sneeze. This is called a hematoma. Both may be initially painful and bulging. The hematoma will resorb over time, a separation of the muscle may need to be repaired surgically. You did not say if you had liposuction with your tummy tuck, but if you did, things can feel firm and bumpy for awhile, up to months. At any rate, waiting is a good course of action. A repair separation will not resolve on its own, but other causes for bumps will. I would not do more liposuction at this point.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.