Upper Abdominal Bulge 8 Weeks After Tummy Tuck with MR? (photo)

Thank you for the question and pictures.

 Based on your pictures, it seems like you have achieved a very nice result after tummy tuck surgery. Frankly, your plastic surgeon's response seems reasonable, again based on your before and after pictures.

Some causes of abdominal wall "swelling" after tummy tuck may be:
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.

  In general, this can be the result of failed plication, fluid collection, intrabdominal fat and extrabdominal fat.  In a lot of women the upper abdomen can appear to have more fat on it due to the fact the the rest of the flap is stretched thinner below.  Liposuction after 3 or 6 months would be appropriate in this case after swelling has resolved.

The upper abdominal fullness certainly can be caused by internal organs, fat or fluid collections beneath the skin.  The fluid collections are diagnosed with a good physical exam.  In some cases the abdomen can not surgically made pancake flat.  These expectations need to be discussed at the consultation. 

 

Dr. ES