Extreme swelling with shooting nerve pain & large blister 8 months post-op - have you seen this before? (Photos)

Question

I had a tummy tuck 8 months ago and had a few stitches spit and a little trouble healing around my drain site. This week I woke up with extreme swelling in my mons area. I also had pain so bad that I couldn’t sleep and at one point I couldn’t even talk through it. 2 days ago I had a large blister show up and is now protruding. Has anyone seen something like this at 8 months post-op?

Semih Yildiz, MD, FEBOPRAS · Answer

Your photos show visible lower abdominal/mons swelling and a protruding blister-like area along the lower tummy tuck scar. New severe pain, sudden swelling, and a blister 8 months after surgery are not expected routine healing changes, and this should be examined in person urgently rather than watched online.

Possible causes include a delayed suture reaction or stitch abscess, an infected fluid collection/seroma, fat necrosis, a wound sinus, or another process that may need drainage, antibiotics, imaging, or wound care. Please contact your surgeon today; if you cannot be seen promptly, or if there is fever, spreading redness, warmth, drainage, worsening swelling, or pain this severe, go to urgent care or the emergency room. Do not pop the blister; keep it clean and covered until you are examined.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding extreme swelling with shooting nerve pain and large blister eight months after your tummy tuck. I suggest you follow up with your plastic surgeon. It could be a collection of fluid like a seroma. This may also require an ultrasound to determine if there is a pocket of fluid. It could also be that you are rejecting or the permanent suture is infected. Permanent sutures are typically used to plicate or bring in the six-pack abdominal muscles. You may have developed a reaction to the suture and are trying to reject it. Finally, the shooting nerve pain may be due to the swelling. If the area is swollen, I would suggest compression. Therefore a tight-fit compression garment is in order til you re-consult with your plastic surgeon—thankyou you for your question regarding shooting nerve pain and swelling eight months after a tummy tuck. 
Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Daniel Barrett, MD · Answer

Dear Sensible561413,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Sameer M. Kapadia, MD · Answer

Hi! 
Sorry to hear you are having problems. The best thing to do is to have your surgeon evaluate you. Sometimes fluid collections can build up even months after surgery. The best course is to make an appointment and let your surgeon evaluate and advise you on a plan moving forward.

Connie Hiers, MD, FACS · Answer

You need to call your surgeon and be seen quickly. You may need antibiotics and may need to be drained. Please don't delay.

Darryl J. Blinski, MD · Answer

The photos posted demonstrates suture abscess. Best to see you operative surgeon ASAP for treatment. Or seek local boarded PS to take on your care. Expect fees incurred in the $1,000+ ranges.

Camille Cash, MD · Answer

I encourage you to return to your surgeon promptly for an examination.  From your description and photos it may be an infection.  Your surgeon will guide you on the next steps after an evaluation.

Mats Hagstrom, MD (license on probation) · Answer

Hopefully by this point you have your situation taken care of. It looks like you have a potentially dangerous infection that needs to be treated or at least evaluated as soon as possible.
I suggest you contact your plastic surgeon immediately and if they can’t get you in today consider going to an emergency room connected to a major hospital that has a plastic surgeon on call.
Best,
Mats Hagstrom MD

Extreme swelling with shooting nerve pain & large blister 8 months post-op - have you seen this before? (Photos)

Answers (8)

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