What Can I Do About Bulging, Sensation Problems After Tummy Tuck?

Question

I had my tummy tuck 7 months ago. Ever since I came out of the surgery, I felt I had a bulge, and it feels like something is moving around inside. After 5 months, other people started noticing my bloated-looking stomach. I started wearing a girdle and waist tights, but it still feels like everything is bulging.
I also don't feel any sensation on the left side of my waist. I told my dr, she said it will get better, but now after 7 months gone, it's still the same. Please tell me what I can do!

Steven H. Williams, MD · Answer

Thanks for your question Reshma -
It depends a bit on what your surgery involved and when you started noticing the bulge.
Abdominal contour is dependent on:
Skin envelope
Abdominal fat (subcutaneous and intrabdominal)
Muscles tightness
Intrinsic Swelling
Fluid collections
Skin Envelope -
People complaining of "abdominal bulge" after tummy tuck typically do not have issues with too much skin - that points to issues underneath the skin.
Abdominal fat -
This can be an issue in people who may be a little bit over their ideal body weight at the time of abdominoplasty. Ways to fix this include the tried and true diet and exercise or liposuction. Be sure to allow enough time between tummy tuck and liposuction to minimize complications.
Muscle tightness -
Muscles plication (or tightening) is usually a part of abdominoplasty. Either failure of the sutures or some laxity can cause a bulge. If the change in your contour was sudden or if you felt a pop - think about the plication having ruptured.
Swelling -
This can be the most common cause of contour issues post-abdominoplasty. Patients typically have swelling for two reasons. First surgery causes trauma and the body's response to trauma is to bring additional fluid into the area that has been traumatized. In addition, abdominoplasty involves dividing lymphatic channels (very very small conduits that normally pull fluid out of tissue) - until these channels grow back the area will not be able to remove excess fluid.
It is usually the most dependent (lowest) part of the surgery that stays swollen the longest.
Fluid collections -
Seromas (serous fluid collections) or hematomas (collections of old blood) can cause distortions of contour. Normally this will improve on its own but may require drainage.
In your case it may be a failure of the muscle plication.  You should be evaluated by your plastic surgeon.  Also consider getting a second opinion.
I hope this helps.

J. Timothy Katzen, MD, FACS · Answer

Hello Reshma. Thank you for your question regarding your concerns after a tummy tuck. Experiencing a bulge and sensation problems post-tummy tuck can be distressing. Given that it's been seven months since your surgery and you're still experiencing these issues, it's essential to address them comprehensively.

Firstly, the bulge you're describing could be due to several factors, including residual swelling, fat necrosis, or even a seroma (fluid collection). Sometimes, the body's healing process can create pockets of fluid or uneven fat distribution that can give the appearance of a bulge. A follow-up examination with your plastic surgeon is crucial. They might recommend an ultrasound or other imaging studies to determine the exact cause of the bulge.

Regarding the sensation problems, it's not uncommon to experience altered sensation or numbness after a tummy tuck. This occurs because nerves are cut during the procedure and take time to heal. While some sensation changes can persist for several months, complete recovery can sometimes take up to a year or more. However, if the sensation hasn't improved at all in seven months, this warrants further investigation by your surgeon.

In conclusion, the best course of action is to continue communicating with your plastic surgeon about your ongoing symptoms. If you feel your concerns are not being adequately addressed, seeking a second opinion from another board-certified plastic surgeon might provide additional insights and peace of mind. Good luck, and I hope this helps to answer your questions regarding post-tummy tuck complications.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Otto Joseph Placik, MD · Answer

Have you gained any weight since surgery. Have started a core strengthening regimen?
If not I would arrange a personal evaluation by an expert in core strengthening and begin a routine. You may also want to consider desensitization therapy as well.

Pat Pazmino, MD, FACS · Answer

Tummy tucks are a very popular and effective way to contour the abdomen. Patients who receive this procedure should anticipate a significant recovery process. In our practice, we inform our patients that they will experience some bruising, swelling, and abnormal sensations in their abdomen for up to 6 to 8 months after surgery. We provide two different compression garments to each patient. These specific garments help compress the area that has been treated as well as provide support for the patient's comfort. At seven months, you're coming to the end of the healing process. It may be normal to have swelling in your describing and you should relay your concerns to your plastic surgeon as they may recommend a compression garment or massage that can help clear up the swelling. The sensations that you are feeling are most likely your nerves growing back. Once they have completed ceiling, you will no longer have these abnormal sensations.

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Steven Wallach, MD · Answer

A bulge after a tummy tuck with sloshing may be a seroma or fluid filled caivty that usually warrants treatment by aspiration of the fluid or even a revision to remove the pseudoburse (capsule).  As for the sensation issue, it may still get better.

What Can I Do About Bulging, Sensation Problems After Tummy Tuck?

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What Can I Do About Bulging, Sensation Problems After Tummy Tuck?

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