Lower abdomen bulge after tummy tuck

Question

I had a tt with umbilical hernia and muscle repair 4 weeks ago. My gap was 5-6 cm. My stomach still looks poochy especially from my belly button down (like 3 months pregnant). My doctor said this is normal swelling but I haven't been doing anything but resting. It's definitely worse at nigbt as well. Shouldn't my stomach be flat by now? I am worried the muscle repair didn't take

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question.  Your surgeon is correct in saying that is most likely still swelling at this point, which could take several months to subside.  Please be patient moving forward and be sure to closely follow the instructions of your surgeon to ensure optimal healing.All the best,Dr. ResultsMiami, FL

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. Even though 4 weeks feels like a long time for you, Swelling after Tummy Tuck can persist for months and it is completely normal that you would have swelling, fluctuating with activity or at different times of the day, and settled mostly into lower areas with gravity.Talk to your Plastic Surgeon about compression, activity restrictions and what to expect as you heal.All the best

Sheila S. Nazarian, MD · Answer

At 4 weeks, it is very common to still be experiencing the kind of swelling that you are describing. Assuming that your stomach doesn't stick out when you are relaxed then your repair is most likely fine. I know it's frustrating, but, for now, be patient and kind to yourself as your body recovers. It can take many months. Best, Dr. Nazarian

Joubin Gabbay, MD · Answer

It is difficult to give you a good sense of what is happening without seeing you in person. That said, it is completely normal to have extensive swelling for several weeks and even months after surgery.I recommend that you stay in close touch with your surgeon to discuss the matter.It is imperative that you seek the advice of a plastic
surgeon who is certified by the American Board of Plastic Surgery and has
extensive experience in tummy tuck/abdominoplasty.

I wish you the best.

Dr. Gabbay.

Bradley A. Hubbard, MD · Answer

Thanks for your question. It is very typical to have swelling in the lower abdomen after a TT. Swelling is especially common in the first 3 months. You need to be examined to be sure there isn't a seroma, but most likely this is swelling that will go away on its own. There is a chance that your muscle repair was not performed "tight enough", but this is much lower on the list of possibilities. I would encourage you to have patience and discuss these issues with your plastic surgeon at your next appointment. Congratulations on your surgery!

William Andrade, MD · Answer

Hello, it is common to have intermittent swelling that is worse at the end of the day, only 4 weeks after a tummy tuck.  This can take months to completely resolve.  In-person assessments are needed to ensure you are healing normally but it wounds like your surgeon is doing ongoing follow-up.

Naveen Setty, MD · Answer

Without seeing any pictures or doing an exam, it is difficult to answer this question.  Swelling after a surgery such as yours can last for several weeks and even up to 3-6 months.  Make sure you communicate your concerns with your surgeon.

Curtis Wong, MD · Answer

do occur and perhaps more so when your gap is as wide as yours was.  Swelling contributes to this as well.  You will be able to test the integrity of your muscle repair after you have completely healed.  If your tummy doesn't protrude out when relaxed when taking showers, its a good sign your repair is intact.  If its fluctuating between morning and night, its a sign of swelling.  Keep your surgeon informed of your concerns as your surgeon is the only one who can really tell you what is happening.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the tummy tuck procedure.
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)  for complete skin redraping  to occur.
I hope this, and the attached link, helps.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Your tummy should be flat after tummy tuck surgery. Please provide a photograph to give you definitive recommendation.

Lower abdomen bulge after tummy tuck

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