Swelling after tummy tuck - does this look normal for 12 weeks? (Photo)

Question

Does this look like normal swelling still 12 weeks after? I am also more full on lower right of my abdomen. I did not have lipo because my dr said I didn't have any fat to lipo, just extra skin.

George Marosan, MD · Answer

Without preop photos and frontal views, it is difficult to comment. You can have swelling up to 3-4 months post surgery especially if liposuction was also done. You state that this is not the case, since you did not have enough fat to suction according to your surgeon. The procedure you had or agreed to is strictly a tummy tuck. In my practice, I find that there are very few cases where liposuction is not incorporated with my tummy tucks. I find that from an aesthetic point of view, a tummy tuck by strict definition is not the same as body contouring. I almost always contour the back waist hips at the same time. Otherwise, one ends up with your result of a flatter tummy and a flat amorphous back without appropriate female curves. Follow up with you surgeon, you might benefit from additional contouring to improve your results. Good luck.

Tom J. Pousti, MD · Answer

“Swelling” 6 weeks after tummy tuck surgery may or may not be normal; it is 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)  for complete skin redraping  to occur.
 Again, please let your plastic surgeon know about the questions/concerns you have. Best wishes.

Khashayar Mohebali, MD, FACS · Answer

Thanks for question but it hard to know without a full set of pictures and exam.  With a proper exam, you can tell what is swelling and what might be residual fatty tissue.  In general, I tell my patients that it will take up to 4 months for the final result.  Follow up with your surgeon to get their opinion.  Also, your results do depend on if you got liposuction (which you state you didn't) and if muscle plication was performed for better abdominal contour.  Good luck with the rest of your recovery and hope you become happy with the results.

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