I'm Nine Days out from Tummy Tuck with Breast Aug and Lift. But my Abdomen Looks Larger Than Before?

I look so much larger that I can't believe the swelling will account for all of the size increase. What are the odds that moving the muscles to a new location will wind up making me look bigger in the end? There are no seromas or hematoma, muscle repair is intact. A day after surgery my legs were swollen, along with my hands. But those have resolved to normal. I don't seem to look like any of the side views I've seen. My flanks also look bigger. It's not weight gain either, I'm sure of it.

Doctor Answers (7)

Swelling after tummy tuck

+4

Hello BusyMom, thanks for the question!  A tummy tuck is a pretty big operation and can result in a lot of swelling. Did you have liposuction with your procedure? I do liposuction of the waist with my tummy tucks, and that makes you even more swollen. That can account for the swelling in your flanks. It's very important to continue to wear your compression garment for at least 6 weeks. After 6 weeks, I have my patients wear a "second stage" garment if they no longer want to wear the compression garment. Massaging these areas can help as well.  It's also important to limit your activity, which can be very difficult for a busy mom!  I hope that helps and wish you all the best!


Fresno Plastic Surgeon
5.0 out of 5 stars 23 reviews

Tummy tuck and Breast Augmentation and lift and early results

+2

At just nine days following a tummy tuck and breast augmentation and breast lift (mommy makeover), you will still be significantly swollen.  Even if there is no visible hematoma or seroma, at this point you may feel and look bigger than you did before the surgery.  It will take at least six to twelve weeks for the post operative swelling to subside.  Wearing a compression garment and watching your salt and fluid intake can help speed this process. Check with your surgeon to make certain you are progressing as they would expect and that you are following their instructions.  But, give the healing process time.  You will probably see a substantial improvement over the next few weeks. Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
5.0 out of 5 stars 17 reviews

Swelling after Tummy Tuck

+1

At 9 days post tummy tuck, it is very common to still have significant swelling.    The abdomen often takes significantly longer than the hands and legs due to the length of the incision.

 

I would continue to wear your binder/garment snug and followup closely with your plastic surgeon to ensure you do not have a fluid collection or infection.   After 4-6 weeks, you should see significant resolution of your swelling.


I wish you a safe and healthy recovery!!

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 39 reviews

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Tummy tucks and swelling.

+1

A tummy tuck or abdominoplasty is a very large procedure which results in considerable swelling which can take 3 months or more to resolve. Many patients feel discouraged early on because they feel that they look heavier than before surgery. Although there are common reasons for an increase in abdominal projection besides flap swelling (constipation, seroma), the usual culprit is retained fluid in the actual abdominal skin and fat. Proper use of garments, activity restrictions, and adhering to the recommended postoperative instructions are imperative. Time and patience are the best solutions.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Swelling after TT

+1

BusyMom:

Try not to be alarmed. It is hard to imagine, in answer to part o f your question, that "moving the muscles" could make you look bigger. They are not actually moved, but just sutured closer to the midline.

It is not surprising that the swelling in your legs and hands resolved first--they were not directly traumatized by the surgery. Just because that swelling is resolved by no means indicates that the abdominal swelling is resolved.

Also common is increased intra-abdominal girth related to the narcotic pain medicine you were probably given. These decrease bowel function and constipation, and it is not uncommon to see the entire abdominal wall to be enlarged early on, and it gets better.

Patience.

Best wishes.

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

Mommy Makeover - Swelling

+1

There are a few key questions you or your surgeon have to answer:  how many days are you after surgery?  Did your surgeon use drains?  Was liposuction also performed?  Was a tumescent technique used for any part of the surgery?

In general, your body does take on some fluid after any longer surgery.  The anesthesiologist is keeping you hydrated with your IV while you are sleeping and that  you saw in your hands and feet.  That fluid you will usually clear out fully in your urine in about 3 days.  Around your the areas of your surgery, some surgeons use drains to remove the swelling fluid and speed your recovery.  Some surgeons will market "tummy tuck without drains" and in my experience these patients stay swollen longer and take longer to recover.  Most swelling around breast surgery and tummy tuck surgery takes approximately 3 months to go away fully.  If liposuction was performed during the tummy tuck surgery, expect that part of your swelling is related to the tumescent fluid used for liposuction.  My retired partner used tumescent fluid during all tummy tucks to allow him to use less anesthesia for the surgery.  In Chicago, numerous plastic surgeons will use this technique and this will increase the amount of fluid seen in the areas around your surgical sites. 

Stefan Mark Szczerba, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 21 reviews

Swelling after Mommy Makeover?

+1

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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 759 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.