Hardness and Lumps After Tummy Tuck?

IT is not unusual ot have lumps particularly in the lower and central portions of the abdomen just above the pubic hairline.
This happens quite frequently.
It will likely resolve and your best guide is to allow time for this.

Thank you for your question regarding the hardness and lumps you’re experiencing six weeks after your tummy tuck.

It’s quite common for patients to notice areas of hardness, swelling, or lumps in the weeks following a tummy tuck. These sensations are often due to the natural healing process, where the body is working to reabsorb fluids and reduce swelling. The tissue under the skin may also feel firm as it adjusts to the changes from surgery. Typically, these lumps and areas of hardness will gradually soften and smooth out over time, though this process can take several weeks to months, depending on how your body heals. The deep tissue massages you’re receiving are an excellent way to help with this, as massaging the treated areas can improve circulation, help break down scar tissue, and encourage lymphatic drainage, which can reduce swelling and lumpiness.

In addition to massages, there are a few other things you can do to help your stomach get softer and achieve smoother curves. Continuing to wear your compression garment as recommended by your surgeon is important because compression helps reduce swelling, supports the tissues as they heal, and can prevent fluid buildup, all of which contribute to a smoother, softer appearance. Staying well-hydrated and maintaining a balanced diet rich in vitamins and nutrients can also support your body's healing process, which may help reduce swelling and improve skin elasticity. However, it’s essential to have patience during this time, as healing from a tummy tuck is a gradual process. While it’s natural to want to see final results quickly, giving your body time to heal is crucial. Most patients notice a significant improvement in firmness and lumpiness within a few months, with continued improvement up to a year post-surgery.

If you’re concerned about the hardness or lumps persisting, or if you notice any unusual changes, it’s a good idea to follow up with your plastic surgeon. They can assess your healing progress and ensure that everything is on track. In some cases, additional treatments, such as ultrasound therapy or additional massages, may be recommended to help you achieve your desired results.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

The wound
healing process following abdominoplasty lasts for over a year.During this time, it’s not unusual for
patients to complain of lumps and areas of hardness.This phenomena occurs for a variety of
reasons. It’s most often related to
swelling, but may also be related to areas of fat necrosis, seromas and
hematomas.In most cases swelling resolves in 4
to 6 weeks, but small amounts of swelling may persist for up to a year.Small areas of fat necrosis, hematomas and
small seromas usually resolve spontaneously, but this may take months.Patients can minimize these problems
with massage and compression garments.It’s also important to discuss this issue with your plastic surgeon.

A lump can be the result of:
1. A hematoma - this should best be drained or removed by your surgeon
2. seroma - a fluid collection under the skin; this should also be removed by your surgeon.
3. Suture material - sometimes, especially in thin people, the suture material can be touched through the skin. If the sutures are disolvable then there is no need to worry but if they are permanent, maybe your doctor can remove some of them.
4. Fat necrosis - this is when some of the fatty tissue dies and it feals like lumps. This would need a more invasive intervention by your doctor; ask!
5. Liposuction swelling - some tummy tucks use liposuction which can leave lumpiness. Be patient--6 months to a year to be sure that this is not permanent.

It is not surprising that you have hard areas, lumps, unevenness in contour after a tummy tuck. There is a lot of scar tissue that needs to decrease and this can take several months. In addition, the fat can also harden giving you some of the lumps. In some instances, there is fluid build-up (seroma) that may need to be drained to remove lumps. Your surgeon should be able to examine you and determine if that is the case.
Massage is very useful in decreasing pain, stiffness, and even swelling. 2-3 massages a week seems a little more than you would need to do. However, if that is helping you then you should continue to do that. Give it some more time, but be sure to talk to your surgeon about your concerns. Good luck.

It is not unusual to have some indurated areas at 6 weeks after this type of surgery.  Massage is good so continue that.  Other things that can help are external ultrasound and endermologie.