Why Do I Have an Issue W/breathing After Tummy Tuck?

Question

I am 6 wks post op from a full tt w/muscle repair all the way up to the rib cage. I developed Atelacstsis of the lungs and was put on Levaquin to help fight any infection that may have been there a few days after my procedure. I have been put on an Inhaler done 5 wks of breathing exercises have had blood work done to make sure there's no blood clot in the body/lungs and although my symptoms have improved I still feel as though it's hard to breathe fully sometimes at night. What can this be?

Jed H. Horowitz, MD, FACS · Answer

the biggest concern is always blood clots,,   your O2 level and  Co2 level can be checked.   as spiral cat scan considered.

	if everything looks good..  it just may be your diaphragm still pushing up .

	rule out  all of the serious issues

Miguel Delgado, MD · Answer

Shortness of breath is a danger sign after a tummy tuck.  This can sometimes be do to thromboembolism which can lead to pulmonary emboli or blood clots to the lungs.  This can cause shortness of breath and even  death.  Your doctor has performed the test to rule out this complication.

When the abdomen is tightened this will compress the inner organs which pushes up on the diaphragm.  This explains why it occurs when lying down sleeping.  Try elevating you back during sleep, this may help

Christopher L. Hess, MD · Answer

It is so common for patients to express this.  When we tighten the abdominal wall muscles we are reducing the volume of the intraabdominal compartment, often substantially. For patients with a small 2cm rectus diastasis the reduction in intraabdominal volume is relatively small.  But for patients who have 4-6cm of rectus diastases this reduction in intraabdominal volume can become huge.  (I won't bore you with the math but is can be impressive). 

	I tell my patients to breath by expanding their backs not their abdomens.  This is because the lungs are situated in the back and this makes it quite easy to "breath through the back."  So relax and relearn to breath.  You'll be happy with your tummy and a new way to breath.

Tom J. Pousti, MD · Answer

Thank you for the question.

	I'm glad that you have had the  most serious  complications such as pneumonia and pulmonary embolism ruled out.  Most likely you are dealing with difficulty breathing because of the increased intra-abdominal pressure after tummy tuck  putting pressure on the diaphragm (and limiting its excursion). You are probably also deconditioned after a period of   relative inactivity  after major surgery.

	I would suggest continued follow-up with your operating surgeon.  I suspect your symptoms will continue to improve  as your  body adapts to the  anatomic changes.

	I hope this helps.

John P. Di Saia, MD · Answer

Hello,

	 

	When you breathe deeply your chest compartment expands a bit into your abdominal compartment. Now your abdominal compartment is tighter with a higher resting pressure. It is a bit harder for you to do what you did before surgery because of this.  I have never had one of my patients describe this for long, but it is possible you were made too tight. Hopefully this will improve with time. Things tend to loosen up with time. This is something to address with your surgeon.

	 

	Best Regards,

	 

	John Di Saia MD

Why Do I Have an Issue W/breathing After Tummy Tuck?

Answers (7)