Lot of Coughing After a Full TT; Bulge at Upper Abdomen, Causes?

i had lot of cough after my full tummy tuck .how to find if my stiches are all ok and not broken.can muscles get tighten in any other way except tummy tuck revision?

Doctor Answers 5

"Bulge" after Tummy Tuck?

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Thank you for the question.
As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.
Abdominal wall "swelling" after tummy tuck may be related to:
1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary. 
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  a complete skin redraping  to occur.
I hope this helps.

Bulging at Upper Abdomen

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There are several reasons why you may be experiencing bulging in the upper abdomen.  Without a physical exam, it is impossible to tell you what may be going on.  If you had a severe bout of coughing, you may have torn some sutures causing a reseparation of your muscles.   If this upper tummy area was flat after surgery, and after coughing, you now notice this bulge - then this could be the reason.   

Another explanation could be you have a fluid collection (seroma)  or a small blood collection (hematoma).   Or this cough just be swelling in an area that is not getting adequate compression.

Please see your PS and have this area evaluated.  Best of luck.


Upper abdominal bulging after Tummy Tuck and Coughing

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There are a few possibilities. If in fact your upper tummy was flat immediately after your tummy tuck then, after severe coughing it suddenly bulged this would point toward either tearing of your stitch line of your mid-line muscles (dehiscence of your upper rectus abdominus repair), or fluid collection (blood or serum- less likely). There are other possibilities but it is a relatively simple matter to schedule and appointment with your surgeon who can sort out your problem by a simple physical exam.

Upper abdominal bulge after tummy tuck

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There are 4 reasons for an upper abdominal bulge following abdominoplasty.   1.  There is a localized pocket of blood, known as a hematoma, in the area.   2.  There is a localized pocket of fluid, known as a seroma, in the area 3.  The sutures from the plication (tightening of the muscles) broke or pulled through 4.  The muscles were tightened too tight below the belly button, or not tight enough above the belly button #1and #2 can be diagnosed with Ultrasound or aspiration ( inserting a needle in the area and withdrawing the fluid)   #3 and #4 are more difficult to diagnose.  If you felt or heard a popping noise or sensation with your cough, I would suspect #3.  If you had the bulge from Post Op Day 1, I would suspect #4.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 25 reviews

Causes for bulging after a tummy tuck

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There are a few causes for bulging after a tummy tuck. One is from fluid which can accumulate after surgery. Early on it would be blood which is why most surgeons put in drains with a tummy tuck to get any blood out that oozes after surgery. A later fluid accumulation would be blood without blood cells which is called a seroma. This would need to be removed by inserting a needle and drawing out the fluid and may need to be done several times. If you had a lot of coughing after surgery, you could have torn out the sutures which could cause a bulge in that area. The only way to fix it is to replace the sutures. To prevent this from happening, I like to double sew the muscle.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

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