Post tummy tuck and lipo post 8 weeks swelling. Could this be swollen scar tissue? (Photo)

Question

Stomach feels very swollen and feels like it is getting tighter and tighter. Could this be swollen scar tissue that will go down or could it be fluid that needs to be drained?

Gary Lawton, MD, FACS · Answer

Swelling after a tummy tuck is normal. Some patients have prolonged swelling. I have seen it for 18 months, then just suddenly resolve. What is clear, however, is that if you listen to your body, the swelling will resolve faster. If there are activities that cause swelling, you must hold off on them until they no longer create an issue. If you try to work through the swelling, it will prolong the process because you are never letting it heal. Everyone is different. People want to get back to their routine and want to see results, fast. The tummy tuck is a big operation that must be respected. If you can exercise without swelling, then you are doing well. If you swell at the end of a day at work at a desk job, then you have to be very careful with your choices, and you must rest as much as possible. After a month, compression also helps

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns with us.At this point (2 months post-po) the swelling is normal.To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts.Kind regards,Dr. Emmanuel Mallol Cotes.-

Jed H. Horowitz, MD, FACS · Answer

Within a few hours following surgery, abdominoplasty patients will walk in a slightly bent-over position. Strenuous activity and lifting of more than 10 pounds should be avoided for six weeks after surgery. Most patients are able to return to work and daily activities within two weeks of surgery.Swelling can persist for several months and will gradually improve and will look better at three months, six months, and even one year. Frequently the pubic area and the scrotal and penis area for men can become very swollen and discolored during the first two weeks due to gravity as this is the lowest area for swelling to accumulate. You can return to full activity without restrictions at 6 weeks.It may take several months for a tummy tuck patient’s scars to soften, for sensation to return, and for relaxing of the tight sensation in the abdomen. In the case of extensive surgery, abdominoplasty recovery can be uncomfortable and may take longer. Scars may stay red, become thick or widen. It can take 12-18 months for the scars to settle.These can be improved with topical treatments such as BioCorneum, Scar Guard, Scar Fade and Mederma. Redness can be improved with laser treatments and the scars can be kept narrow with products such as Embrace.  On occasion, keloids or hypertrophic scars can develop and will need treatment including Kenalog, 5FU and laser.As questions arise with the healing process, regarding swelling, scars, infections or others, it is always best to visit your surgeon to have the area examined and make sure that healing is progressing as it should. There is always the potential for a problem and your own surgeon knows your personal case the best and can give the most experienced advice. Good luck.

Shlomo Widder, MD · Answer

Dear Nina,     Thanks for submitting your post operative pictures. From observing your pictures, you appear to have protrusion of your upper and lower abdomen. After 8 weeks from your surgery, it is unlikely that you have seroma, but it will need to be ruled out by your surgeon. Most likely it is laxity of the abdominal muscles from the following possible reasons:    1. Too much fat in the abdominal cavity. That can be ruled out by having you lie down flat on your back. If your stomach is flat, than your problem is muscle laxity. If your stomach is still protruding, than the intra abdominal fat is causing the protrusion and you need to lose weight.2. You did too much strenuous activity, too early, which stretched the muscle repair. It is not uncommon that patients do not follow doctor's instruction which can affect the final result. 3. Your surgeon used absorbing sutures or did not tighten enough your muscles. Unlikely if your surgeon is experienced board certified plastic surgeon. 4. You did not wear a protective abdominal Velcro binder. All my patients wear it for 3-4 weeks.   In summary, you have to return to your surgeon for evaluation and planing of  corrective measures.                       Best of luck,                                     Dr Widder

Michele A. Shermak, MD · Answer

Hello!
In the case of having a muscle repair, there could be bloating that may last up to a year. It's certainly worth visiting your plastic surgeon to assess the situation in person. I encourage walking, low salt diet. By 8 weeks I encourage increasing physical activity.