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Why Would I Still Have a Knot Above Belly Button, 15 Months After my Abdominolplasty? (photo)

I had an abdominolplasty 15 months ago and still have a protruding bulge/hard knot above my belly button (about 1 inch). I am still being told that it is swelling. History: I was able to almost fully stand up straight the night I went home from the surgery and would walk myself to and from the bathroom...do you think I did somthing? It is really bothering me, but I am just told to come in every three months for a follow up. Do you have any suggestions? Thank you,

Doctor Answers (7)

Protruding Bulge above Belly Button 15 Months after Tummy Tuck

+3

   The protruding bulge could be due to lax fascia.  If this a knot or hard rather than soft, this is not likely the case.  More likely would be a permanent suture remnant, exuberant scar, or walled off flluid collection.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 220 reviews

Bulge 15 months after Tummy Tuck- is this permanent?

+3

At 12 to 15 months, you should be seeing the final result.  This means that swelling has disappeared and now the underlying structures can be more visible.  If the bulge does not change in size and is not painful, this most likely represents the base or stalk of the reattached umbilicus.  The visible portion of the belly button hangs lower than the base and now the base is visible.  Sometimes liposuction can help this secondarily, especially if the bulge is fatty in nature.  Otherwise, this can be a weakness in the muscle repair to tighten the belly or true hernia missed at the time of surgery.  A plastic surgeon who is double board certified in Plastic Surgery and General Surgery would be best to manage this problem.  Sometimes a larger more diffuse bulge can be seen after tummy tuck when a muscle repair is only done below the umbilicus but not above it (as in a "mini" abdominoplasty).   Your operative note from the surgeon would state that this was the case.  All in all, if you are 15 months out from surgery and you have a bulge, it is likely permanent and you should discuss this with your surgeon or seek a second opinion for corrective surgery.

Michael Zenn, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 1 review

Knot above umbilicus

+3

Thanks for your inquiry and phots, but without an exam it is hard to tell.  You could have a separation in your muscle repair if you had a muscle repair done.  It could also be a hernia or scar tissue.  You should schedule an appointment with yuor surgeon and discuss further.  Good luck.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

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Knot Above Belly Button, 15 Months After my Abdominolplasty

+2

Without a physical exam, it is not possible to tell what this is. Possibilities include a hernia, and area of breakdown of the muscle tightening (assuming that was done), an area of "fat necrosis" which is scar in fat that lost blood supply during or after the surgery. 

At 15 months it is unlikely that there is still swelling that will resolve. Ask your surgeon, consider second opinion if needed. 

Thanks and best wishes. 

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

Lump after tummy tuck

+2

At 15 months, you should be near the final result.  To me, it looks as if there is uneven pull on the fascia (strength layer), with more tension bell the umbilicus.  Conversely, did you have a mini tummy tuck?  I think it unlikely that you did anything wrong here.

 

I would suggest that on your next visit, ask the surgeon complete details of the surgery, including where he put the fascia sutures.  Ask him to examine to check the integrity of the repair.

 

A revision may be needed, but don't stress about it at this point.

 

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 49 reviews

Why would I still have a not above bellybutton after 15 months

+1

I think the knot that you're feeling is probably the suture used to tighten your rectus abdominus or six pack muscles. When an abdominoplasty or tummy tuck is performed usually the rectus abdominus muscle is tightened. This is done with permanent suture from the sternum or breastplate to the bellybutton. Another suture tightens the muscle from the belly button to the pubic region. Typically, the suture used to tighten the muscle is permanent suture. Permanent suture means this suture should last your lifetime. Often the body develops significant scar tissue around this permanent suture. This is the most likely cause of your pain. Other possibilities include a seroma, which is a collection of fluid. Another possibility is fat necrosis which is where a small pocket of fat dies. Another possibility is a hernia, among others. Please follow up with your board-certified plastic surgeon. Good luck. Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 27 reviews

Recurrent bulge following an abdominoplasty

+1

There are several possibilities but the most likely one is recurrent laxity of the anterior abdominal fascia.  It is possible that your tissues in this area were not very good and have stretched out again.  It appears that the fascia below the umbilicus has done quite well.   It this particular situation you definitely need a physical examination.  If you do a crunch and this area bulges then you have your answer.   If it does not bulge then it is a soft tissue problem.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 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.