How Long Should Swelling Last After Full TT, MR, Lipo and Fatty Necrosis?

Hello. I will be five weeks post op tomorrow from a full tummy tuck, muscle repair, and UAL of my flanks. I developed fatty necrosis where my "old umbelicus" was pulled down and there is now a vertical incision. It has been sharps debrided four times and I clean it twice daily while alternating wet to dry dressings and Silvadene. It is closing in nicely, finally, but I feel like I am growing more swollen. Will I ever be flat? It doesn't feel like it. I am 5'0"; 119 lbs. I know it takes time.

Doctor Answers 1

Swelling after Tummy Tuck and Complications?

Thank you for the question.

I'm sorry to hear about the comp patients you have experienced after tummy tuck surgery.

Especially given your complicated . Of course, make sure you see your plastic surgeon with any new finding such as increased swelling, redness, increased discharge, fevers etc. He/she is in the best position  to give you good advice...

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.

I hope this helps.

San Diego Plastic Surgeon
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