I am 5 weeks post tummy tuck. My upper abs are very flat but right below my incision is extremely distended . It's as though I have a donut around my belly. My PS says this is where the swelling naturally travels but I keep wondering if it is a seroma. I cannot find pictures of a seroma on the web. the area is even all the way around . I cannot fit into my old clothes and am worried. Please help.
Could Distended Lower Abs After Tummy Tuck Be A Seroma?
Doctor Answers (9)
Fluid feel of seroma after tummy tuck
A seroma will feel full and heavy and typically have a fluid wave as you tap over the full area. Swelling is more stiff and spongy. If there is doubt, your surgeon can aspirate the area to see if a fluid collection is present.
Best of luck, peterejohnsonmd.com
Swelling after Tummy Tuck Surgery?
Thank you for the question.
As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.
Abdominal wall "swelling" after tummy tuck may be related to:
1. Swelling in the soft tissues. This may take several months to resolve and may worsen with increased activity or at the end of the day. Patience is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle. this may consist of blood ( hematoma) or serum (seroma). This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound may be helpful). Treatment consists of aspiration; several episodes of aspiration may be necessary.
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication) of the rectus muscles. These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year (or greater) a complete skin redraping to occur.
I hope this helps.
Distended after tummy tuck
It is perfectly normal to have some swelling at this stage, however you could very well have a seroma. It is impossible to say without seeing you. A seroma is a fluid collection that will often feel water balloon like when you push on it. Sometimes you can push on one side and feel a wave of fluid move around the tummy. I would have your surgeon look at it because I don't think photos will tell you one way or another. Good luck!
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Pablo Prichard, MD
Swelling versus seroma
Thank you for the question. At 5 weeks out after your tummy tuck even fullness below your incision line can be either swelling or a seroma. Your plastic surgeon can evaluate you best to determine which of these issues is occurring. Sometimes an ultrasound or a CT scan is needed to evaluate for a pseudo bursa but more often the physical exam is sufficient.
All the best,
Dr. Remus Repta
It is possible, but less likely at 5 to 6 weeks after surgery. Positioning , garment use, and activity levels all can affect the swelling -and therefore early appearance of your abdomen at this time frame. I f you see a "wave' under the swollen area when you push on the skin- then it may be a seroma. Best to follow up with your surgeon.
If you have a seroma in the lower abdomen, there is often a fluid shift that is palpable. You may even be able to shake and feel fluid move around.
This could represent normal swelling or a seroma. If it is flatter in the morning, but distends more during the day, it is more likely swelling. If it stays the same during the day, it may be a seroma. A fluid wave as described below indicates a seroma. An ultrasound can be done if there is a question. Sometimes in people with thicker tissue, it is difficult to feel a fluid wave and they can have a seroma that is difficult to diagnose.
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.