Hi, thank you for reaching out with your concerns about abdominal swelling six months post-tummy tuck, and for providing your pictures. Evaluating the Cause: Abdominal swelling at this stage post-surgery warrants attention. It's possible that this could be due to an increase in visceral fat (the fat behind the abdominal muscle) or an issue with the muscle itself. Weight Changes: Have you experienced any significant weight gain recently? An increase in visceral fat could result in the abdomen protruding as seen in your photos. Muscle Integrity: The condition of the rectus abdominis muscle is also crucial. If it was sutured during your tummy tuck, there's a possibility that the sutures may have loosened. If there was no muscle plication, or if it wasn't sufficiently tight, this could also contribute to the current appearance. Recommended Actions: Weight Check: Compare your current weight with your pre-surgery weight. Imaging: An MRI can be helpful to assess for increased visceral fat or to evaluate the condition of the rectus muscle. Consultation: Most importantly, schedule a follow-up with your plastic surgeon. They can provide a thorough examination and guide you on the next steps, considering your specific surgical history and current condition. Remember, every surgical outcome is unique, and your surgeon is best positioned to advise you based on your individual case. I hope this guidance helps you in addressing your concerns about the swelling. Here's to a smooth resolution and continued recovery. Sincerely, Dr. Katzen