Hardened Tissue After Tummy Tuck

While tissue edema can definitely contribute to areas of fullness and firmness after an abdominoplasty, this phenomenon should be well resolved by the time frame you are referencing (3 years). It may be fat necrosis, scar, poor midline tissue redraping, seroma, ventral hernia, et cetera. I would recommend meeting with your board certified plastic surgeon to discuss your concerns and possible solutions. 

Hello Shelia Ann, thank you for your question regarding hardened tissue after your tummy tuck. Experiencing hardened tissue several years after a tummy tuck can be a common occurrence and is often due to scar tissue formation or fibrosis. Scar tissue can develop and sometimes become more noticeable over time, leading to areas of firmness or hardness under the skin.

There are a few approaches you can take to help soften this hardened tissue:

Massage Therapy: Regularly massaging the hardened areas can help to break down scar tissue and improve blood circulation. Using gentle, circular motions with a moisturizing lotion or oil can be beneficial. This should be done consistently over time for the best results.

Ultrasound Therapy: Some physical therapists offer ultrasound treatments that can help to break down scar tissue and soften hardened areas. This non-invasive therapy uses sound waves to penetrate deep into the tissues, promoting healing and flexibility.

Scar Tissue Injections: In some cases, corticosteroid injections can be used to reduce the hardness of scar tissue. This treatment should be administered by a qualified medical professional.

Consulting with a Plastic Surgeon: It may be helpful to follow up with your plastic surgeon to discuss your concerns. They can provide a thorough evaluation and may recommend additional treatments such as laser therapy or further surgical interventions if necessary.

Remember, it is important to consult with a healthcare professional before starting any new treatments to ensure they are appropriate for your specific situation.

Good luck, and I hope this helps address your concerns about the hardened tissue after your tummy tuck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Thank you for your question.  Three years after surgery, the scars should be matured and healed.  This could be scar build-up and an evaluation by your plastic surgeon to determine if any thing can be done to treat this problem.

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.

The hardness you are experiencing is normal a few months after surgery but not 3 years. I would recommend you contact your surgeon and be evaluated to be sure that nothing is wrong. Best of luck.

Occasionally hard tissue after a tummy tuck may be a sign of fat necrosis or of plicated tissues. Discuss this with your surgeon. Other than resecting the tissue, I am not sure if much can be done. Early on, fibrotic tissues can be softened with intralesional steroid injections but scar maturation should have occured by 3 years and are not likely to be improved at this point.

Seromas are occasional complications after an abdominoplasty.  This is a collection of fluid that is often treated with repeat aspirations in the doctor's office.  Left untreated, they can organize and effective be replaced by scar tissue.  It might take years for this to resolve if my guess is correct.  It is not dangerous, however.

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.

Thank you for your post. In tummy tuck and other lift/tightening surgeries, tension is the enemy. The scar is healing gradually over 12 weeks or so, and until it is strong, it is the weakest link. As there is a great deal of tension in tummy tucks, body lifts, breast lifts, etc., the scar is at high risk of 'stretching' or widening. Silicone sheeting, although having the ability to make a scar flat, does nothing to prevent stretching of the scar. Creams or steroids or lasers also do not have the ability to prevent stretching of the scar. Those are used if scar is thick or dark, but not to reduce the wideness of the scar, which is the main problem. Massage also does not help keep the scar thin, and can actually worsen the scar in the first 12 weeks because you are actually adding tension to the scar. Massage is for softening a hard or thick scar, but if used early, will hasten the scar widening. Only tension reduction has the ability to keep the scar as thin as possible. You may notice in a lot of tummy tuck scars that the center portion of the scar is the widest with the sides toward the hips being the thinnest. This is because the maximum tension is at the center, and least amount on the sides. Embrace removes a lot of the tension by putting more tension on the skin on either side of the incision and drawing the incision together. It is expensive though at about $100 per week for 12 weeks. When patients do not want to spend the money for embrace, I tape the incision trying to remove as much tension as possible for 12 weeks and recommend no stretching back and to sit most of the time, keeping tension off the scar.Best wishes,Pablo Prichard, MD

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.