April 9,2012 Full Tummy Tuck, Very Very Swollen? No Fluid Pockets

I had a breast reduction in 2010, and a tummy tuck April 9, 2012. To this day I am very swollen, 2 weeks after surgery my stomach was totally flat. At about 6 weeks after my stomach and belly button region started to swell. I had a ct scan and mti done as well as an ultrasound. I have no fluid of fat at all. I am very disapointed and my surgeon seems to be dumb founded.I get asked when I am due! I am 45 yrs old. Please help.

Doctor Answers 7

Fuller abdomen despite a tummy tuck.

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This is an unusual situation to have a flat stomach at 6 weeks and a full stomach at 6 months without fluid collection. The most obvious cause would be weight gain with a increase in your intra-abdominal fat. This causes an increase in pressure inside the abdominal cavity and leads to a bulging of the abdomen (the male equivalent is the "beer gut"). Another consideration is abdominal wall laxity. If the issues are related to weight, obviously a healthy diet and weight loss will help. Abdominal core exercises can help with a flaccid abdominal wall to improve contour.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Recurrence of abdominal bulge following an abdominoplasty

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An abdominoplasty should be a one time procedure.  I understand your frustration. You  did not mention if you have gained any weight since your surgery as no body contouring procedure is a substitute for a healthy lifestyle.  If your abdomen is larger than expected now and was flat at 6 weeks and your weight is stable and you have been checked for fluid collections then the other possibility is recurrent laxity of the anterior abdominal wall.  You should be examined your plastic surgeon, he is in the best position  to determine the what is causing your problem.  The swelling may be due to visceral fat or recurrent laxity of the fascia.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Swelling after Tummy Tuck?

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Thank you for the question.
As always, it is best to be seen in person ( by your plastic surgeon and/or a second opinion plastic surgeon consultant) 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.

Swelling after tummy tuck

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Hello Leslie, thanks for your question!  Swelling after a tummy tuck, especially when combined with liposuction, may last up to a year. However, by 8 months, the majority of this should be resolved.  It's good that the CT and MRI showed no fluid collection (seroma) or blood collection (hematoma).  You may still have some residual swelling from the surgery, so it wouldn't hurt to try a compression garment.

Also, it's VERY common for people to gain weight after surgery.  Being sedentary and unable to exercise for weeks after the surgery can certainly lead to weight gain. I advise my patients to maintain a healthy lifestyle with a great diet and exercise program after their surgery.

And of course, it never hurts to get a second opinion from a board certified plastic surgeon.

I hope that helps and wish you all the best!

Tummy Tuck and Swelling

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Based on the information you provided, I suggest you seek a second opinion.  Consult with a Board Certified Plastic Surgeon for an evaluation, and to discuss your expectations and concerns.  Be sure to take a copy of your operative report with you to your appointment.  Best of luck to you!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Full Tummy Tuck, Very Very Swollen

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By six months there should not be swelling of such significance. It would be most helpful to see some photos, both current and from before surgery before making a comment. 

One possibility that comes to mind is that the abdominal muscle plication failed sometime after two weeks. Other than fluid collection which seems to be excluded by the studies, I cannot think of another likely explanation. 

Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

8 Months after Tummy Tuck and Still Swollen? Fluid Collection Ruled Out

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  There should be very little swelling at 8 months following tummy tuck, and a larger contour could be due to weight gain or failure of plication.

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.