Bulging Lower Abdomen After Tummy Tuck

Thanks for your question -
It depends a bit on what your surgery involved and when you started noticing the bulge.
Abdominal contour is dependent on:
Skin envelope
Abdominal fat (subcutaneous and intrabdominal)
Muscles tightness
Intrinsic Swelling
Fluid collections
Skin Envelope -
People complaining of "abdominal bulge" after tummy tuck typically do not have issues with too much skin - that points to issues underneath the skin.
Abdominal fat -
This can be an issue in people who may be a little bit over their ideal body weight at the time of abdominoplasty. Ways to fix this include the tried and true diet and exercise or liposuction. Be sure to allow enough time between tummy tuck and liposuction to minimize complications.
Muscle tightness -
Muscles plication (or tightening) is usually a part of abdominoplasty. Either failure of the sutures or some laxity can cause a bulge. If the change in your contour was sudden or if you felt a pop - think about the plication having ruptured.
Swelling -
This can be the most common cause of contour issues post-abdominoplasty. Patients typically have swelling for two reasons. First surgery causes trauma and the body's response to trauma is to bring additional fluid into the area that has been traumatized. In addition, abdominoplasty involves dividing lymphatic channels (very very small conduits that normally pull fluid out of tissue) - until these channels grow back the area will not be able to remove excess fluid.
It is usually the most dependent (lowest) part of the surgery that stays swollen the longest.
Fluid collections -
Seromas (serous fluid collections) or hematomas (collections of old blood) can cause distortions of contour. Normally this will improve on its own but may require drainage.
I hope this helps.

Thank you for your question regarding the appearance of a bulging lower abdomen five weeks after your tummy tuck. At this stage in your recovery, what you're seeing is most likely swelling, which is a normal part of the healing process. It can take several months for the swelling to fully subside, particularly in the lower abdomen, as this area tends to retain fluid for a longer period.

Swelling can fluctuate, especially after activities like exercise or standing for long periods, and it’s common for patients to feel frustrated when they don’t see immediate results. If you're 10 pounds overweight, some of what you're noticing could also be residual fat, but it’s too early to determine whether a revision or additional liposuction is necessary.

To help with swelling, wearing your compression garment as recommended by your surgeon is crucial, as it helps reduce fluid buildup and promotes healing. Additionally, staying active with light walking, drinking plenty of water, and avoiding salty foods can help reduce bloating and swelling.

I recommend giving your body more time to heal—most surgeons wait at least 6 to 12 months before considering any revisions, as the final results can take that long to be fully visible. If you're still concerned after that period, a follow-up with your surgeon can help determine if further procedures are necessary.

Sincerely,
Dr. Katzen

Thank you for your question.After your #tummytuck surgery, #swelling can persist for several months and will gradually improve and will look better at three months, six months, and even one year. Frequently the pubic area can become very swollen and discolored during the first two weeks due to gravity as this is the lowest area for swelling to accumulate.If you have concerns, contact your #BoardCertified #PlasticSurgeon.

It’s not unusual for patients to complain of fullness and
swelling for several months following abdominoplasty. The wound healing process
following this procedure lasts for over a year. Most of the swelling resolves
in six to eight weeks, but small amounts of swelling may persist for up to a
year. The procedure inevitably interrupts the abdominal lymphatic drainage and
this takes time to re-establish itself. Patients
can minimize swelling with compression garments, massage and limitations on
activity levels. It’s important to remember that swelling is a normal part of
wound healing and should resolve with time.

Swelling is a normal aspect of any surgical procedure. This can be asymmetric. There are also other causes of swelling such as a fluid collection or a hematoma. If there are questions you should see your plastic surgeon.

A tummy tuck or abdominoplasty is an extensive operation with a lot of post operative swelling.  It usually takes 3- months before the swelling subsides.  Please be patient and keep in close contact with your PS during the recovery period.  

Based on your pictures I would be surprised if it was anything other than post operative swelling.  If you do have some localized fullness after the swelling has subsided, you would be a candidate for a non surgical touch up procedure such as Coolsculpting, Endermologie or may a little office liposuction touch up.  Most surgeons would offer the touch up without further financial considerations.

Hello,

Bulging in lower abdomen can be secondary to:

1) fat

2) swelling

3) seroma/hematoma

4) abdominal wall

If the soft-issue under the skin seems to be the same thickness (the amount that you can grab) then it is not likely that fat is the kajor source.  At 5 weeks you may still have swelling although you should be seeing a slow decrease.  A seroma or hematoma would be diagnosed by your plastic surgeon and certainly present with oither sypmtoms.  It may be the case that your abdominal wall has not been tightened enough.  I would wait longer for healing to occurr and have your plastic surgeon re-assess you.

All the best,

Dr Repta

At 5 weeks post-op surgery, it is still too soon for you to see the final result of your surgery. Generally, swelling can last up to 4-6 months. Things should tighten up and swelling should subside by the time you are 6 months. 

Three factors could cause this bulge:1. Swelling: It should go away in 4-6 weeks or so.2. Excess fat: Liposuction would address this problem.3. Muscle weakness: Unlikely early after a tummy tuck ,the answer is another plication of the muscle fascia.Hope that helps!