Failed tummy tuck (muscle repair) or swelling? (Photo)

I am sorry to hear about your concerns. Online consultants will not be able to differentiate intra-abdominal adipose tissue,  muscle laxity,  residual subcutaneous adipose tissue, from persistent swelling…  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. 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. Separation of the abdominal wall plication is very unusual.



 



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. 

Thank you for your question and series of photographs and I am sorry that your results have not been what you anticipated.  It is difficult without an in-person examination to determine what may be taking place.  Most commonly this is residual swelling from surgery which will spontaneously resolve but it would be important to voice your concerns to your surgeon to ensure that other issues are not taking place - discrete fluid collection, muscle laxity, or residual adipose tissue.