6 Months Post-Op Tummy Tuck - Still Numb And Very Swollen - Is This Normal?

Hello! Thank you for your question! Numbness after any surgical
procedure is expected for several weeks to months following. As the
nerves to the area are traumatized and will then experience a temporary
neuropraxia, a transient loss of nerve conduction. This usually
resolves over the next 6-12 weeks, but depending on the procedure
performed, sometimes much longer. Typically this should resolve by 1
year. As it goes past this date, the likelihood of the sensation
returning is small. However, it can take up to 2 years. If no return
from there, it is unlikely to return. It should be discussed that
persistent sensory changes may develop following any surgical
procedure. The usual signs of the nerves regenerating and neuropraxia
resolving is itching, followed by a burning sensation and then
occasional sharp, shock-like pains. These will be normal to experience,
and actually a promising sign. Usually, normal sensation returns, but
is is also possible to have decreased sensation or even increased
sensation to the areas affected. Re-educating nerves postoperatively is
often helpful and will allow proper instruction for the affected
sensory nerves - methods include using different textures to the
affected areas when showering, bathing, applying lotion, etc. If
bothersome, there are some medications that may be helpful, including
Neurontin for pain for hypersensitivity. You can try various textures
such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is
also beneficial for the incision to make the finest scar possible. The
last place to regain the sensation will be directly adjacent to the
incision/scar as the nerves will make its way from the periphery to this
location. If continual pain arises, evaluation is warranted. After
ruling out other causes, one rare explanation may be that a neuroma has
developed and may require surgical excision. This is very unlikely
unless a large sensory nerve has been transected inadvertently during
the procedure. Hope that this helps! Best wishes!

The wound
healing process following abdominoplasty lasts for over a year. During this time, both swelling and numbness
are often present.Most swelling resolves in six to eight
weeks, but small amounts of swelling may persist for up to a year. Patients can minimize swelling with
compression garments, massage, and limitations on activity level.It’s important to remember that swelling is a
normal part of wound healing and should resolve with time.In the vast majority of patients,
numbness is temporary and resolves in about a year.Sensation tends to first return laterally and
superiorly and move downward and inward.The last place to have return of sensation is the area near the
transverse incision below the umbilicus.In some cases loss of sensation may be permanent.

It is common to feel sore and have swelling even so many months after your tummy tuck, particularly if you've exercised or physically exerted yourself. You may want to cut back on the physical activity a bit to minimize this. However you should not be so swollen that you can't fit into your pre-op clothing. I recommend you see your surgeon to discuss your concerns. 

While most patients feel quite normal after 6 months, many patients heal more slowly.

It is worth discussing your problems with your plastic surgeon.  Is there retained fluid?  Is there extra fat or skin?

If you do not fit into your old clothes, this is decidedly unusual.  Have you gained weight?

Patients who are active, work out, and stretch have fewer of these types of complaints.

Numbness is typical but the nerve symptoms you may be having may warrant further therapy.

I agree with my colleagues and without seeing pictures and examining you, I cannot really give you my recommendations.  I do think its abnormal to be that swollen and in pain.  At the very least, I would recommend a series of post-lymphatic massages (sometimes even with ultrasound technology) which may help to break up any scar tissue and can also help with edema resolution; however there may be more going on such as a chronic seroma or fluid collection.  I would go back to see your plastic surgeon; however, it is never a bad idea get a second opinion from another board certified plastic surgeon.

Your swelling at 6 months should be pretty much resolved.  Without before and after pictures, it is impossible to give you specific advice.  Sometimes if the incision was not long enough for if there was too much fat to be treated at the same time as surgery you could end up with a "dog ear" at the edges of the incision.  I am not sure if this is what you are referring to.  Regardless, it I think it is importation that you follow up with your surgeon for an evaluation.

 

Good Luck.

Some patients need more time than others.  Sometimes after a tummy tuck the discomfort can persist for a very long time.  I've seen this sort of thing happen to all different types of surgery patients.  Some can be after breast augmentation, sometimes for breast reconstruction.  It's important to know that these surgeries can require rearrangment of anatomy such as tighten the abdominal muscles and move them towards the center or rearrange the belly button and it's location on your skin.  Consider how long this would take to return to normalcy.  Many are very much in touch with their body and can feel more than others do.  This could be your case.  Best wishes,

Certain positions can cause
some discomfort.  Sit straight and try to
get up to move frequently, this will help with the swelling.

If your lower abdomen was flat at first and now it is swollen this is normal. As you get more active the fluid between the cells, called interstitial fluid tends to accumulate above the scar. The scar works as a dam. It takes about 3 months for the lymphatic vessels to re-form and properly drain this dependent edema. Give it a chance and it will get better. If in doubt discuss this with your plastic surgeon.

Thank you for your post. In a tummy tuck or abdominoplasty surgery, the tissue above the abdominal muscles is lifted off of the muscles from the lower scar to the ribs in a full tummy tuck and to the umbilicus in a mini tummy tuck. The superficial nerves that travel through the muscle to the skin are cut in order to do this. This is what causes the numbness afterward. The numbness usually extends in the entire area that was lifted up. On occasion, a superficial nerve to the thigh could be pulled causing numbness in this area as well. Swelling happens after surgery and also tends to be in the entire area that has been lifted up and any area that has received liposuction. Both numbness and swelling may take months to years to go away, and the last place for both to go away is the area right above the incision centrally, and sometimes right below the belly button. It may take up to 2 years to get to baseline sensation. sometimes, certain areas never feel totally normal, especially the area right above the incision centrally. If tingling or itchiness develop, that is a sign that the nerves are growing back. This is normally well tolerated, but occasionally, a nerve type pain medication is needed such as neurontin. Best Wishes, Pablo Prichard, MD