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Solution for Prolonged Abdominal Swelling After Tummy Surgery?

I had tummy tuck surgery on 12/26/08. I lost a drain 10 days after, then my right side started swelling. My dr. did additional surgery after 1mo to repair my navel and replace the drain. He said I had a seroma, but after surgery, he said it wasn't a seroma. He removed the drains 1mo later.

The swelling never got better but extended to the left side and pubic area. I have no pain, just discomfort from pressure. Intercourse is painful. He said he'd do lipo after 6mos, but I'm afraid it won't help... what can I do?

Doctor Answers (5)

Surgical Options after Tummy Tuck

+3

Thanks for the question -

Based on your picture (and please note that a complete history and physical and report of your two previous surgeries would be required for a final plan) it appears that a re-do abdominoplasty would be a good option for you.

Here's why:
It appears that you have some additional skin, you have a scar beneath the umbilicus that would be removed with a repeat abdominoplasty and scar tissue from your seroma/hematoma could be addressed. In addition you may benefit from additional muscle plication. (You could also possible include the drain scars and bring the drains through the abdominoplasty scar next time).

Abdominal contour is dependent on:
Skin envelope
Abdominal fat (subcutaneous and intrabdominal)
Muscles tightness
Intrinsic Swelling
Fluid collections

Skin Envelope -
People complaining of "abdominal bulge" after tummy tuck typically do not have issues with too much skin - that points to issues underneath the skin.

Abdominal fat -
This can be an issue in people who may be a little bit over their ideal body weight at the time of abdominoplasty. Ways to fix this include the tried and true diet and exercise or liposuction. Be sure to allow enough time between tummy tuck and liposuction to minimize complications.

Muscle tightness -
Muscles plication (or tightening) is usually a part of abdominoplasty. Either failure of the sutures or some laxity can cause a bulge. If the change in your contour was sudden or if you felt a pop - think about the plication having ruptured.

Swelling -
This can be the most common cause of contour issues post-abdominoplasty. Patients typically have swelling for two reasons. First surgery causes trauma and the body's response to trauma is to bring additional fluid into the area that has been traumatized. In addition, abdominoplasty involves dividing lymphatic channels (very very small conduits that normally pull fluid out of tissue) - until these channels grow back the area will not be able to remove excess fluid.
It is usually the most dependent (lowest) part of the surgery that stays swollen the longest.

Fluid collections -
Seromas (serous fluid collections) or hematomas (collections of old blood) can cause distortions of contour. Normally this will improve on its own but may require drainage.

I hope this helps.


San Francisco Plastic Surgeon
4.5 out of 5 stars 23 reviews

Get a second opinion- this can be fixed!

+2

Tummy tucks are a very popular and effective way to contour the abdomen. Patients who receive this procedure should anticipate a significant recovery which will consist of discomfort, bruising, and prolonged swelling. It is possible that the component of your persistent swelling may be a collection of fluid or blood that occurred after the surgery. Your body may have created some scar tissue around his collection, making the swelling worse. If this is the case, you should work with a board-certified plastic surgeon who has a great deal of experience and abdominoplasty and abdominal recontouring. They will assess your abdomen and help determine the cause of the swelling. Your plastic surgeon may recommend a technique such as ultrasound assisted liposuction or a small revision of your tummy tuck to access this area and remove the scar tissue or collection.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:
 

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 63 reviews

Get a second opinion

+2

It is difficult to tell exactly what is going on from the photos, but from the history it certainly seems like you developed a seroma. I agree that additional surgery, which would include a revision of the abdominoplasty with liposuction for better contour is indicated, but I would probably get an ultrasound of the abdomen before surgery.

Elizabeth A. Kinsley, MD
Covington Plastic Surgeon
4.0 out of 5 stars 4 reviews

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Uneven swelling in lower abdomen after tummy tuck

+1

It is truly difficult to assess your condition from the information given and it appears that your surgeon never provided you with an explanation for the swelling. From his/her recommendation, it sounds as if it is due to fat deposits as indicated from their advice for staged liposuction at a later date which may be a reasonable approach.

Otto Joseph Placik, MD
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Abdominopalsty problem

+1

It is hard to say what the problem is at this point. It could be a persistent seroma or something else. It should be evlauated.

Steven Wallach, MD
Manhattan Plastic Surgeon
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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.