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Is this swelling or just left over fat and this is my result? (photo)

I am 4 weeks PO, I still seem to have this belly that looks pregnant. It does swell more as the day goes on and looks bigger...my question is does this look like swelling? Or left over fat and this is my result? I have yet at any time seen a flat (or even close to flat) stomach under there. The bulge is a little smaller in the morning, but it is will there. Do you think this will go down more? I have added a before and after.

Doctor Answers (1)

Is this swelling or just left over fat and this is my result?

+1

Thank you for the question and pictures.

It is always best to be seen in person (by your plastic surgeon) for precise diagnosis and treatment.

Generally speaking, 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.


San Diego Plastic Surgeon
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