Bulge Above Belly Button After Tummy Tuck...What is It?

Question

I am 4.5 months post op from full TT. 6 wks post op I became ill w/ violent cough, sneezing. I was very flat for 6 wks po..then a bulge began. PS says it's fat and he wants to lipo. I explained that does not make sense b/c it was flat before and also it's in the place were I feel so much strain when I sneeze/cough..and I have a hard bulge..bulge flattens some with rest. He said he did 1 layer of sutures. I suspect a muscle repair issue. Could muscle be swollen, but repair intact?

Richard H. Tholen, MD, FACS · Answer

Although swelling can be more or less in some areas after surgery, you did NOT suddenly develop fat in your upper abdomen that you didn't have before your 6 week post-op coughing, sneezing illness! Flat before and bulge after does indeed sound as if the muscle repair may have been disrupted. Straight-leg raising while reclining can stress the abdominal wall and show any weakness in the area of your bulge, so this is relatively easy to test.

	However, I have seen many tummy tuck patients who have a residual bulge in the upper abdomen (although it's there right away after surgery, not suddenly appearing after a cold and coughing jag) since it is often unsafe to deal with excess upper abdominal fat at the time of tummy tuck because of circulation concerns. In these cases, later liposuction is certainly appropriate and effective.

	You just don't want your surgeon inadvertently puncturing protruding bowel rather than removing excess fat!

	If in fact your muscle repair has disrupted, there is no "easy" way to re-repair it without waiting an appropriate length of time for everything to soften and mature, and then re-doing the tummy tuck to get back to that surgical area. Of course, an incision could be made in the upper abdomen over the bulge (just as a general surgeons does when fixing a hernia), but that sort of destroys the "cosmetic" nature of a tummy tuck. Perhaps an endoscopic approach could be considered. But most of us would rather not have to re-do the entire tummy tuck, so any other (safe) solution tends to be considered first. Sorry for the reality check. Best wishes!

Yily De Los Santos, MD · Answer

Thank you for your question. It would give us a better idea of what you mean if you send pictures. A bulge is more commonly formed under the belly button during swelling process, as the liquid starts going down, to determine what's causing a sudden bulge over the bellybutton would require more evaluation.

Kevin Brenner, MD, FACS · Answer

A bulge that occurs in the upper abdomen following a coughing spell...six weeks after a tummy tuck, is most likely a rupture of the suture plication. This can repaired, but requires that the entire flap be re-elevated.

Elizabeth Slass Lee, MD · Answer

A sudden bulge following a cough or sneeze soon after tummy tuck surgery can be from a few things.  One of them is a tear in the muscle repair., but another possibility may be from a small amount of bleeding that can occur where a suture pulled with the sneeze.  This is called a hematoma.  Both may be initially painful and bulging.  The hematoma will resorb over time, a separation of the muscle may need to be repaired surgically.  You did not say if you had liposuction with your tummy tuck, but if you did, things can feel firm and bumpy for awhile, up to months.  At any rate, waiting is a good course of action.  A repair separation will not resolve on its own, but other causes for bumps will.  I would not do more liposuction at this point.

Miguel Delgado, MD · Answer

It is possible that with the coughing spell early in the post op period, you may have popped some sutures with the facia repair.  The muscle is not swollen at this point and it is only one of two things.  Failed facia repair due to the coughing issue or fat.  Your plastic surgeon knows the difference. you can do a sit up and see if the bulge occurs.

Bulge Above Belly Button After Tummy Tuck...What is It?

Answers (8)

Answer: Several things can cause sudden bulge after tummy tuck

Answer: Several things can cause sudden bulge after tummy tuck

Answer: Upper bulge after tummy tuck

Answer: Upper bulge after tummy tuck

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Bulge Above Belly Button After Tummy Tuck...What is It?

Answers (8)

Answer: Several things can cause sudden bulge after tummy tuck

Answer: Several things can cause sudden bulge after tummy tuck

Answer: Upper bulge after tummy tuck

Answer: Upper bulge after tummy tuck

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.