Is this pooch just swelling, Fat, something that needs further assistance? Will it flatten out for the final result? (photos)

I have had this pooch that seems to hang out over my incision since the first week. It's only in the lower abdomen just above the incision,Which gives it this weird look. I am 5 wks post op,I Know I have more healing to do.I don't see my PS again for 2 more mo. exactly.he is revising my old belly button scar since it didn't heal right. Is this pooch just swelling?Fat?Something that needs further assistance? Will it completely flatten out for the final result? I'm worried it will stay this way :(

Doctor Answers 3

Pooch at the bottom of a TT

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Dear jlong826, the pooch at the bottom of the TT is very common for 2 reasons.  First is swelling.  Swelling goes down by gravity and the location of the pooch is the lowest position of the TT.  The incission stops the swelling from going down further so it pools exactly there.  Most likely that's your case.  The swelling can be persistent and it can last for 3 to 6 months.  You've probably noticed that the area of swelling is also very numb.  That's also normal and the fact that that area has lost in nervation makes the swelling harder to get rid of.  The second reason to have the pouch is retained fat in the area.  Normally the fat of that part of the abdomen is thicker than the pubic area and it would form a step off if the surgeon doesn't take care of that discrepancy at the time of surgery.  I do it with liposuction but it can also be done by cutting the thickness down with scissors or knife or a combination of all of the above.  If the retained fat and discrepancy is large then the pooch and step off will not go away.  The good news is that it can easily be corrected with a touch of liposuction if it's still there 3 to 6 months after the original surgery.  There's some other reasons for the pooch although not as common as the ones discussed.  You can have a small hematoma (collection of blood that  that formed after surgery or even a seroma that produce a pooch by occupying space.  In order to diagnose that (if it's not clinically obvious) sometimes we can resort to high resolution Ultrasound, CT scan or MRI. And last the sutures used to bring your abdominal muscles together can break or fail producing a bulge like that.  The best thing you can do is regular follow ups with your doctor until the problem goes away or your doctor decides to fix it .  Good luck in your recovery.

Oklahoma City Plastic Surgeon

Pouch over the incision

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That seems to be the combination of both: swelling and fat (just remember liposuction can not be done during Tummy Tuck, so some fat there is only expected) and after 4-6 months lipo will fix that completely.
That little dog ear should be fix too in the combination of the other revision. 
Be encouraged. You will be loving your results. 
Dr. Cardenas

Tummy tuck recovery

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Did you have any liposuction.  This important because it can be responsible for more swelling.  Otherwise a physical exam is needed to give you further help.

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