What could this lump next to belly button be? (Photo)

Question

I've already asked if this could be a muscle repair failure, but wanted to ask if it could be anything else. As you can see from pics, lump isn't visible when standing. Only lying down. I had a seroma at 2 weeks PO in that area which was aspirated. Could that be the cause of the hard lump, or maybe fat necrosis? I can feel the hardness to left of my belly button but also behind my belly button if I press inside it. Right side of stomach is soft. Thank you

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the lump next to your belly button. Lumps in the abdominal area after a tummy tuck are not uncommon, and there are several potential causes. Based on your history and photos, it could be related to a few possibilities, especially given that you had a seroma earlier.

Here are some of the potential causes of your lump:

Seroma: Since you had a seroma aspirated in that area, it’s possible that the lump is residual scar tissue from the seroma or even a small recurrence. Seromas can sometimes leave hardened areas after the fluid is removed.

Fat Necrosis: This occurs when fat cells die due to reduced blood supply after surgery, and it can cause lumps that are firm to the touch. Fat necrosis is typically benign but may feel hard under the skin.

Scar Tissue: It’s normal for scar tissue to form after surgery. This could be related to the sutures used in the muscle repair or even a natural part of your body’s healing process. Sometimes knots from the running sutures placed to repair the rectus abdominis muscles can create a palpable lump.

Hematoma: A collection of blood, though less likely at this stage of healing, could still present as a lump, particularly if the area was previously filled with fluid.

Ventral Hernia: This type of hernia can cause a bulge near the belly button, especially when lying down. However, hernias usually present as lumps that come and go depending on your position and activity level.

To get a definitive diagnosis, I recommend having an MRI or ultrasound. These imaging tests will help your surgeon and radiologist determine exactly what’s causing the lump and guide your next steps for treatment.

I hope this helps answer your question and provides clarity on your situation.

Sincerely,
Dr. Katzen

Camille Cash, MD · Answer

This lump that you have could be a number of things including many of the possibilities that you mentioned.  The only way to know for sure is through further imaging studies such as an ultrasound or perhaps an MRI.  Start by visiting with your surgeon for an examination.  She/He can determine the best "next steps".

Mats Hagstrom, MD (license on probation) · Answer

It’s difficult to give you quality assessment based on the information provided.
It’s possible that you have a chronic seroma.
You could easily assess that with an ultrasound.
Most likely, the contour is a representation of the shape of your abdominal wall.
Some people have one side of the abdominal wall that projects more than the other.
During muscle tightening Can be some uneven contour of the abdominal wall.
My best guess is that is what this represents, and it may or may not be related to how the procedure was done.
It could be a combination of anatomic variance and simply having the procedure.
At this point, it may be better to simply accept the outcome for what it is.
Either way to make any changes is going to require surgical intervention.
I’m not sure the surgery is going to make a big difference unless you have proven chronic seroma.
Best,
Mats Hagstrom MD

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