Hardened Tissue After Tummy Tuck

Hi, I just wanted to ask if there should be tissue or muscle that is extremely hardened under the skin of the abdomen, after a 3 year old tummy tuck. Maybe this is scar tissue build up?

Can I do anything to soften the feel of it? The hardened area is mostly above my belly button and outward about 4 inches on each side of my belly button. Please advise with any suggestions or remedies.

Doctor Answers 14

There shouldn't be hard areas after 3 years

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After 3 years, all the healing and tissue softening from a tummy tuck has occurred. There shouldn't be any hard areas left over at this point.

Either you have scar tissue in the muscle from tightening it or you have hard lumps in the fat where the blood supply was injured. These areas are called "fat necrosis."

It is probably too late to massage these areas and soften them. Unless they could be removed safely, I suspect these are permanent.

Hardening Following Tummy Tuck

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The hardness in the area beneath your umbilicus is probably related to fat necrosis and scar formation.  This phenomena occurs because of compromised blood flow to the involved area.  In the initial phases of wound healing some remodeling can be expected, but after 12-18 months these changes are more or less permanent without secondary surgery. 

                  It’s hard to make a recommendation without performing a physical exam.   Depending on the results of this exam a variety of options may be available.  In some cases revision abdominoplasty may be necessary, while in other cases surgery may not be an option.

                   If you’re concerned about this problem, consultation with a board certified plastic surgeon is appropriate.  This surgeon should be able to make an appropriate recommendation.

Hard Tissue Should be Evaluated

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Hard spots should be gone three years after Tummy Tuck.

Have your surgeon evaluate these spots to determine if anything need be done.

Hard areas after a tummy tuck

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Firmness in the soft tissue is normal up to a year or so after a tummy tuck. Unless there is significant scarring, it is unlikely to remain firm at 3 years. I would recommend a full evaluation with your plastic surgeon. In cases of "abdominal etching" where the goal is to effectively scar the dermis or skin down to the abdominal wall to give the illusion of a six-pack, this firmness is expected. Over-aggressive liposuction of the skin flap can give this same quality of "stuck down" skin. Treatments are few but include fat transfer or dermal fat grafting. Thankfully, this complication is quite uncommon. Review your issues with your plastic surgeon to identify the underlying problem and your treatment options.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Hard tissue after tummy tuck

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Patients who received tummy tucks love their new tight abdomens and the way they look in their clothes. However, patients should anticipate a significant recovery process. For the first several months after their surgery, is expected to have significant swelling and firmness. In our practice, we provide our patients with two postoperative compression garments to help manage this swelling. At this time, you should revisit with your surgeon to determine if these areas you are feeling are from swelling or from a collection of blood or fluid. Your surgeon may recommend compression garments, warm compresses or evacuation of the fluid if it is present.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Tummy Tuck hardness

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These areas of hardness you describe are abnormal to persist after three years.

You need full evaluation and I am surprised your surgeon did not continue to follow up with your progress. These can be scar or Fat Necrosis.

You need to see Board Certified PS and be evaluated and discuss your options.

Samir Shureih, MD
Baltimore Plastic Surgeon

Hard Feeling Areas after a Tummy Tuck

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The scar healing and maturation process goes on for up to a year. By then, everything becomes soft and if need be, other operations can be done and the tissue will feel and behave like NON-operated tissue.

In your case, three years SHOULD have more than allowed all the areas to soften. Persistent hardness is either due to excessive scarring (most Likely) or to an area where the fat died (fat necrosis) and was replaced by scar tissue (less likely in this area above the belly button).

You should see your original surgeon and have him examine you. He would know what he did and what would be needed to fix it.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Hardened tissue after three years should be evaluated

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It can be normal to have hardened tissue within the first year after a tummy tuck. This can be scar tissue, or some small areas of fat necrosis (fat that loses blood supply). However, after three years, this is probably not the case and especially not in the location that your describe. It could be a suture reaction where the muscles may have been tightened or it could be areas of fat necrosis or even (but less likely) some small hernias in your muscle. I would have this evaluated by a plastic surgeon.

Get examined

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This may be scar tissue that you are feeeling below the skin or even an old seroma cavity.  You should see your surgeon to examine you.

Not usually

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While it is normal to have some areas of hardness in the first few months after a tummy tuck most of these should resolve over the course of several months. After 3 years, you are probably feeling some areas of fat necrosis or if your skin is really thinned out, you may be feeling some areas of the abdominal wall muscle. I would recommend you go see your surgeon and get his / her opinion. I agree that massage at this point probably won't help.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.