I am noticing a pooch after my tummy tuck. Should I be worried?

Question

I am about 6 weeks post op from my tummy tuck and I am noticing that my lower stomach is starting to pooch a little when I am not sucking in. Should I be worried?

Steven J. Rottman, MD, FACS · Answer

Thank you for your question and photos. You should expect to have swelling for three to six months following tummy tuck surgery. Use of a properly fitted compression garment will help decrease the length and severity of the post-operative swelling. As the swelling decreases, the contour of your abdomen, flanks, and hips will dramatically improve. Please follow your plastic surgeons specific advice regarding your level of physical activity. Hope this helps and good luck with your recovery.

Bryan Armijo, MD · Answer

You should follow up with your surgeon throughout the recovery process, especially if you have some concerns.  This "pooch" likely represents normal post-operative swelling; however, a visit with your surgeon can help rule out something more concerning such as a seroma.

Jeffrey G. Lind II, MD · Answer

Thanks for your question.  As others have stated, it will be several months before you know your final results.  You should address any concerns that you have with your surgeon.  Best of luck to you.

R. Scott Yarish, MD · Answer

What you are concerned about could easily be swelling, especially if it seemed to have accumulated after your drains were removed.  Discuss it with your surgeon if it doesn't resolve or at least improve in the next 2-3 months.

Tom J. Pousti, MD · Answer

I'm sorry to hear about the concerns you have after tummy tuck surgery.  As you likely know, your plastic surgeon will be your best resource for precise diagnosis...
Generally speaking, an abdominal wall "pooch" after tummy tuck may be related to:
1. Swelling in the soft tissues. This may take several months to resolve and may worsen with increased activity or at the end of the day. Patience is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle. this may consist of blood ( hematoma) or serum (seroma). This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound may be helpful). Treatment consists of aspiration; several episodes of aspiration may be necessary. 
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance.  One of the steps of a tummy tuck procedure involves reapproximation (plication) of the rectus muscles. These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
 
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year (or greater) a complete skin redraping to occur.
   
Best wishes.

Thomas Trey Sands, MD · Answer

Thank you for your question. You are still very early post op from you surgery so there will still be a lot of changes as the swelling goes down. This typically takes at least 3 months. I would encourage you to be patient but also have close follow up with your surgeon to make sure that he or she is able to exam you to monitor your progress.

Lisa M. DiFrancesco, MD · Answer

Thank you for your questions. 6 weeks post op is still too early to determine your final post op results. If you have concerns discuss them with your surgeon at your post op visit.

Lawrence Bundrick, MD (retired) · Answer

6 weeks is still very early into your recovery. It could take 3-6 months, and even up until a year before all swelling subsides and you see your final results from a tummy tuck procedure.

I am noticing a pooch after my tummy tuck. Should I be worried?

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