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Swelling from Naval to Pubis 10 Weeks After Tummy Tuck? (photo)

I had an extended tummy tuck 10 wks ago. My drains were in14 days, then removed only because the PS doesn't allow them in longer. Afterward I developed an infection at the drain site which was treated w/antibiotics & resolved. Now I notice that I have swelling in a very distinct area of my abdomen, beginning right below my naval & extending all the way into the pubis about 6" across. It is also quite numb. I now have a "pot belly," NOT the look I was after. What is this & will it go away w/time?

Doctor Answers (8)

Swelling from navel to pubis 10 weeks after tummy tuck?

+1
Hello! Thank you for your question! Numbness after any surgical procedure is expected for several weeks to months following. As the nerves to the area are traumatized and will then experience a temporary neuropraxia, a transient loss of nerve conduction. This usually resolves over the next 6-12 weeks, but depending on the procedure performed, sometimes much longer. Typically this should resolve by 1 year. As it goes past this date, the likelihood of the sensation returning is small. However, it can take up to 2 years. If no return from there, it is unlikely to return. It should be discussed that persistent sensory changes may develop following any surgical procedure.

The usual signs of the nerves regenerating and neuropraxia resolving is itching, followed by a burning sensation and then occasional sharp, shock-like pains. These will be normal to experience, and actually a promising sign. Usually, normal sensation returns, but is is also possible to have decreased sensation or even increased sensation to the areas affected. Re-educating nerves postoperatively is often helpful and will allow proper instruction for the affected sensory nerves - methods include using different textures to the affected areas when showering, bathing, applying lotion, etc. If bothersome, there are some medications that may be helpful, including Neurontin for pain for hypersensitivity. You can try various textures such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is also beneficial for the incision to make the finest scar possible. The last place to regain the sensation will be directly adjacent to the incision/scar as the nerves will make its way from the periphery to this location. If continual pain arises, evaluation is warranted. After ruling out other causes, one rare explanation may be that a neuroma has developed and may require surgical excision. This is very unlikely unless a large sensory nerve has been transected inadvertently during the procedure. Hope that this helps! Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Numbness and Swelling post tummy tuck

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Thank you for your post. In a tummy tuck or abdominoplasty surgery, the tissue above the abdominal muscles is lifted off of the muscles from the lower scar to the ribs in a full tummy tuck and to the umbilicus in a mini tummy tuck. The superficial nerves that travel through the muscle to the skin are cut in order to do this. This is what causes the numbness afterward. The numbness usually extends in the entire area that was lifted up. On occasion, a superficial nerve to the thigh could be pulled causing numbness in this area as well. Swelling happens after surgery and also tends to be in the entire area that has been lifted up and any area that has received liposuction. Both numbness and swelling may take months to years to go away, and the last place for both to go away is the area right above the incision centrally, and sometimes right below the belly button. It may take up to 2 years to get to baseline sensation. sometimes, certain areas never feel totally normal, especially the area right above the incision centrally. If tingling or itchiness develop, that is a sign that the nerves are growing back. This is normally well tolerated, but occasionally, a nerve type pain medication is needed such as neurontin.
Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 27 reviews

Swelling after Tummy Tuck

+1

According to your information it appears you were still having drainage two weeks postop.  It is quite likely that you have continued to accumulate swelling fluid after removal of your drains and this has resulted in a seroma.  Your surgeon should be able to determine this by physical examination and treat it with aspiration.  Multiple aspirations may be necessary and wearing a compression garment should be helpful.  Numbness is to be expected and should gradually improve over time.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 33 reviews

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Swelling from Naval to Pubis

+1

Thanks for your question. I cannot tell much from the photo, but from the narrative it seems that you may have a fluid collection, or seroma. Your surgeon should be able to tell this quite readily at the time of an examination, and the treatment is aspiration. Occasionally this is required several times. Replacing a drain is another possibility. 

Numbness is universal after TT. Some sensation will return gradually over the course of a year. 

This will go away, but with intervention.  (There are other possible causes, but the time course you describe makes a seroma seem most likely.)

Thanks and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Post operative swelling after tummy tuck

+1

Swelling follows all surgeries.  This is a necessary part of the healing process. However, if you have swelling that is recent and has developed since the drains have been removed, the evidence is strong that you have developed a seroma. This is a fluid collection that can be  aspirated in your doctors office. 

The numbness is standard and will improve with time. 

A follow up visit with your surgeon will help clear up some of these questions. 

Douglas Hargrave, M.D.

 

 

Douglas Hargrave, MD
Albany Plastic Surgeon
5.0 out of 5 stars 17 reviews

You will want to make sure that you do not have a seroma

+1

Hello,

Thank you for the question and photo.  I would make sure that you have not developed a seroma.  Swelling below your belly button this late after your tummy tuck may be a seroma.  If it is a seroma you will want the fluid drained until it no longer collects.

All the best,

Dr Remus Repta 

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 92 reviews

Swelling and numbness after tummy tuck

+1

You just might have a small seroma causing the lower fullness, and support such as a Spanx can help it resolve. Numbness is the rule after tummy tuck, and will take a full nine months to get better.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

See your surgeon. Then wait.

+1

First of all, let your surgeon see you to make certain you do not have an infection (abscess) or fluid collection (seroma) causing the swelling. If none of those are present, you will need to wait a few months before assesing the final result as swelling can remain for quite a while after surgery and should continue to improve. If after it stops improving there is still more skin and fat than you would like, you may consider having it tightened up further with a smaller procedure. You may wonder why it wasn't pulled as tight as possible the first time. The answer is because there is a limit to how tight your surgeon can pull things together before there is a risk of the skin dying or not healing which are even more undesirable than a little residual pooch. 

Armin Moshyedi, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 5 reviews

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.