3 1/2 Months Post Tummy Tuck Still Swollen an Very Very Tight, Normal??

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.

The wound
healing process following abdominoplasty lasts for over a year.Most of the swelling resolves in six to eight
weeks but small amounts of swelling may persist for up to a year.The procedure inevitably interrupts the
abdominal lymphatic drainage, and this takes time to re-establish itself.Patients can minimize swelling with
compression garments, massage, low salt diets and limitations on activity
levels.It’s important to remember that
swelling is a normal part of wound healing, and should resolve with time.Significant swelling three months
after abdominoplasty should be evaluated by your surgeon.In the vast majority of cases, this swelling
is probably normal, but in a small percentage of patients it might represent a
problem.Seroma formation, low grade
infection, and separation of the muscle closure might be possible explanations
for your pain and swelling.In some
cases further studies may be necessary to resolve this issue.If you continue to have problems with
persistent pain and swelling it’s imperative that you be re-evaluated by your
plastic surgeon.

Your swelling and tightness should be going down by now. At this point you may want to try therapeutic or "lymphatic massage" as it is often helpful following Tummy Tuck and liposuction (Smart Lipo, Vaser, Tickle lipo, or conventional lipo) to minimize swelling. Not all plastic surgeons recommend it nor is it mandatory. Make sure your surgeon feels that you have healed sufficiently  and it is safe before doing this.  Endermologie is also very helpful after Tummy tuck with liposculpture/liposuction but again, not critical.  Although deep tissue massage following liposuction can aid in smoothing out  contour irregularities that invariably accompany this procedure it has limited effect on the final outcome and  is NOT mandatory. Some plastic surgeons recommend it to all  patients as they feel the edema resolves faster.  Ask your surgeon to show you or a significant other how to do this if cost is an issue. Typically they will have you massage toward areas of maximum lymphatic drainage ( for example groin or armpits) A low sodium diet and no heavy exercise especially lifting for the first 4-6 weeks may also be helpful. Low impact low resistance but high repetition exercise may also be useful at this point.