Is peripheral edema 4 days post op from panniculectomy normal?

I am 4 days post op from a panniculectomy and abdominal scar revision. Today, I noticed both of my lower legs are a little swollen. It could have been there before today, and I just not noticed it. It's stage 1 pitting. There is no pain or redness. I walk around several times a day. I am also sleeping in a recliner with my body higher than my legs. I know it is normal for my torso/pelvic area to have swelling (which it does), but is it normal for my lower legs to be swelling?

Doctor Answers 1

Swelling After Panniculectomy

Based on the history you provided, this is most likely just fluid retention.  After surgery, the body perceives it has been injured (which it has) and a hormone (anti-diuretic hormone) is secreted which causes generalized (not just in the area operated on) water retention.  This fluid will tend to pool in the most dependent area, namely the lower legs and feet.  It is made worse with prolonged standing and keeping the lower legs and feet hanging down.  Treatment is leg elevation and compression stockings.  In rare cases, a diuretic is needed.

However, in the early post-op course, one needs to be concerned about the less likely, but MUCH more serious possibility of blood clots in the legs.  This usually happens on only one side and is usually a sudden change.  But it can happen in the way you have described.  If left untreated, clots can migrate to the lung (pulmonary embolism), which can be life-threatening.  For this reason, I STRONGLY recommend you discuss your situation immediately with your Plastic Surgeon, so the appropriate work-up and treatment can be started.

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