I'm 5 months post tummy tuck. Should I still be swollen? (Photo)

Thank you very much for sharing your concerns with us.At this point (5 months post-po) the swelling has to be minimal.To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts.Kind regards,Dr. Emmanuel Mallol Cotes.-

Thank you for your picture.  It is difficult to see any swelling in your photo.  It is possible still to have swelling 5 months from surgery.  Please continue close follow-up with your plastic surgeon to determine the cause and most effective management. Best wishes.

Thank you for your question.Based on the photo you posted it is difficult to see any abnormal swelling.Swelling after a tummy tuck could be due to following reasons:1) a fluid collection - serous fluid or blood - this is very rare2) actual 'swelling' - after surgery it is normal for the operated tissues to be swollen.  Your entire body may seem swollen immediately after the surgery as it is normal to retain water during the first few weeks.  However such swelling is long gone after 5 months.  In rare situations, some operated areas remain swollen for a long time because it takes a while for the lymphatic circulation to be re-established and this would be seen in the midline just above the tummy tuck scar as this is the last area to normalize.  This is the area limited to the space between the scar and the belly button3) most common cause of patients seeing 'swelling' is lower abdominal bulging.  The abdominal wall is usually tightened during the tummy tuck.  However, the lower abdomen is naturally weaker than the upper abdomen and so it tends to protrude more, creating the lower belly pouch look (the fascial layer has three layers in the upper abdomen but only two below the belly button).  This is not swelling and it will not go away with time.  This is normal anatomy and gravity working together.  Strengthening your lower abdominal muscles and weight loss (to reduce your intra-abdominal cavity fullness) is the real treatment.

Congratulations on your tummy tuck.A tummy tuck involves removing excess skin and tightening the abdominal wall."New swelling" months after a procedure is usually bloating.  Your own intra-abdominal contents may be expanding as they normally may be do (as with gas) which can push on the tightened abdominal wall, causing you to feel like the area is swollen.  Bloating will change everyday, and will subside, but you may notice it more now that everything is tighter. The swelling is unlikely to be related to fluid or actual swelling of the tissues this long after surgery.Losing weight or abdominal muscles will help.

Swelling after tummy tuck can take 6 months or more to resolve.  The process should be gradual with swelling overall decreasing over that time period.  Most often there is dramatic decrease in the first 6-8 weeks and then slowly decreasing after that but each person is different.  Swelling may increase after physical activity.  If you have noticed a dramatic increase in swelling I would recommend you contact a board certified plastic surgeon to be evaluated.  

I'm sorry to hear about your concerns after tummy tuck surgery.  Your plastic surgeon will be your best resource for precise diagnosis and treatment. Generally speaking, abdominal wall "swelling" 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. This may be diagnosed on physical examination with your surgeon examining you in different bodily positions. 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.