I'm 7 Weeks Post Op, and I'm Bigger Than I Was At Week 4. Do I Need a 2nd Tummy Tuck?

I'm almost 7 weeks post tummy tuck and not satisfied with results. I am not flat at all and I have a distention with pain on the left side over the belly button. I was more flat at week 4 and then had this abdominal distention. I never did any extra effort during recovery period and wondering why my results are like this. It is depressing not to be flat after all this.

Doctor Answers 4

Swelling after tummy tuck

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Thanks for your question. Since you are only 7 weeks after your tummy tuck, you are still in the very early stages of healing and you still have a significant amount of swelling. You will not see your final results for several months. Another possible cause is a fluid collection, also called a seroma.  You need to be seen in person to diagnose this, so you should keep your follow up appointments with your plastic surgeon. And I would advise you to continue wearing your compression garment.

Swelling after a tummy tuck will take at least several months to resolve, and sometimes up to a year.  I hope that helps and with you all the best.

Tummy Tuck Results?

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Thank you for the question.

Based on your description of being "distended" now  compared to the 4 week mark,  you may be dealing with some swelling. As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.

Generally, 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.

Larger at week 7 than at week 4

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It's impossible to answer this without an examination. Return to your surgeon to be evaluated.

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Need a Second Tummy Tuck?

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It is much to early to determine if you need a second procedure.  It is interesting that you feel you were flatter at week 4 than you are now.  That may imply either you have some swelling or perhaps there is fluid accumulation.  Of course it is impossible to know without an exam so this is something you need to address with your plastic surgeon.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 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.