One side of my tummy tuck is more swollen. Is it because they left more fat?

Question

I had a lipo suction and tummy tuck 3 weeks ago and one side looks bigger , is it because they left more fat or ? Thank you

Thomas A. Pane, MD · Answer

This early from surgery it may only be a slight difference in swelling.  Other causes are best evaluated in-person.  Depending on the thickness of your abdominal wall prior to surgery, it is possible that one side is in fact bigger and due only to the anatomy.  Your surgeon can give a better assessment by examining you.

Nelson Castillo, MD · Answer

Thank you for your question and I am sorry that your results have not been what you anticipated.  It is difficult without an in-person examination to determine what may be taking place.  Most commonly this is residual swelling from surgery which will spontaneously resolve but it would be important to voice your concerns to your surgeon to ensure that other issues are not taking place - discrete fluid collection, muscle laxity, or residual adipose tissue.

George Bitar, MD · Answer

There are several possible explanations for the asymmetry.  First, your swelling may be uneven due to post operative activity or even positioning (that is, the tendency to lean towards or lay on one side more than the other).  Second, you may have developed a post operative seroma or fluid collection, accounting for the larger side.  Third, it is possible that fat removal was uneven.  I would suggest that you follow up with your operative surgeon for a careful examination and to discuss your concerns.  Best wishes for an easy recovery.

Farah Naz Khan, MD · Answer

At only 3 weeks, it's hard to comment on your results. It's normal to be swollen after lipo/TT so best to allow all of the swelling to resolve before you evaluate your results. And, both sides do not necessarily heal at the same rate! Continue wearing your garment and following up with your PS. Good luck!

Sheila S. Nazarian, MD · Answer

Asymmetric healing is very common with all surgery. It could be that you use that side more. Is it the same side as your "handedness" -- i.e. right side if you are right handed? Nothing to worry about unless it doesn't improve with time. Then, see your surgeon.My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your post and provided picture as well. Is really
 hard to tell without photo.  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.Good luck :)

Chen Lee, MD · Answer

Abdominal liposuction results in significant surgical trauma of the fat lying under the skin.  As a result tissue fluid collection, tissue swelling, and fibrosis can lead to varying degrees of temporary surface irregularities that often resolves spontaneously in the 6-8 weeks following a procedure.  3 weeks is too early to assess long-term outcome.  Be patient and maintain follow-up visits with your plastic surgeon.

Vincent D. Lepore, MD (retired) · Answer

At just three weeks post op, it is difficult to say what is causing one side of the tummy tuck to look larger.  At this point you are probably still swollen and may have more fluid (seroma) on one side than the other.  Let your surgeon know about your concerns.  If the asymmetry is due to fluid or swelling, it may well resolve over the next several weeks.  If there is a significant amount of fluid accumulation your surgeon may want to aspirate it with a needle.  Best wishes, Dr. Lepore.

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