Pouch and swelling 3 years after tummy tuck. How can I treat this? (Photo)

Well, first of all the scar is way too high, at all points along its course. And this is part of the problem you're having with the prominence above the scar; the scar is contracted a bit and pulling itself and surrounding skin downward toward your abdominal wall, enhancing the excess volume of tissue above. The way to fix this problem is a revision of the abdominal portion of the scar with advancement inferiorly. Liposuction will only partially fix the problem of the bulge, and will do nothing for the unaesthetic high scar position.

Hello Avill87, thank you for your question regarding a pouch and swelling 3 years after a tummy tuck.

It is not uncommon to experience changes in your abdomen years after a tummy tuck. To determine the exact cause of the pouch and swelling you're experiencing, I recommend starting with an ultrasound. An ultrasound will help identify whether the pouch is due to fluid accumulation (such as a seroma) or fat.

If the ultrasound reveals that the pouch is fluid, the treatment may involve drainage. This is a relatively simple procedure that can be done in your surgeon's office. On the other hand, if the pouch is fat, this may indicate weight gain around your abdomen.

Here are a few steps you can take to address this issue:

Weight Management: If the pouch is due to fat, weight loss through diet and exercise is the most effective way to reduce it. Engaging in regular cardiovascular exercise and strength training can help burn fat and tone your abdominal muscles.

Dietary Adjustments: Adopting a healthy diet that includes plenty of fruits, vegetables, lean proteins, and whole grains can aid in weight loss. Avoiding processed foods and sugary drinks is also crucial.

Weight Loss Medications: If diet and exercise alone are not enough, you may consider weight loss medications like Zepbound. These medications can assist in reducing fat but should be used under the supervision of a healthcare provider.

Compression Garments: Wearing compression garments can help reduce swelling and support your abdominal muscles. However, they are not a long-term solution for reducing fat.

Follow-Up with Your Surgeon: Regular follow-ups with your plastic surgeon are essential. They can monitor your progress and suggest additional treatments if necessary. If the pouch is significantly bothersome and does not respond to weight loss or other measures, revision liposuction or another surgical procedure might be an option.

It's important to understand that while a tummy tuck can provide significant improvement in your abdominal contour, maintaining those results requires a healthy lifestyle. Weight fluctuations can affect the long-term outcomes of your surgery.

Good luck, and I wish you all the best in addressing your concerns. Thank you for your question regarding the pouch and swelling after a tummy tuck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

The first step would be to see your surgeon or a board certified plastic surgeon to ensure that you aren't holding any fluid in this area such as a delayed seroma. There are times following surgery that excess swelling in the lower abdomen can cause some loose skin that may require a surgical revision. It is unlikely that noninvasive skin tightening devices will be effective.

An examination is needed to determine what may be causing the pouch and swelling you are experiencing. If it is fluid then it's possible it can be drained. If it is subcutaneous fat you may be able to address it through localized liposuction. If it is internal/visceral fat then weight loss will improve the contour.

Based on your posted photo, I would recommend a ultrasound of lower abdomen to see if the pouching is due to excess fat, fluid, soma. After the ultrasound, then possible revision of the lower tummy tuck with excision of scar and liposuction and and layered repair. Fee $8000-$15,000. Best of virtual consult with.

It appears that you have gained some weight. Try to decrease your calorie intake and loose pounds. then, you will notice being flat again.