Bulging Lower Abdomen After Tummy Tuck

My lower abdomen looks round and fat 5 weeks after Tummy Tuck! How can you tell if it is swelling or the final result of the tummy tuck? Any tips? I look pregnant in the lower area. I'm 10 lbs overweight and I'm not sure if I need a revision or more Lipo.

Doctor Answers 8

Tummy Tuck Bulge

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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.

Post op Swelling after Tummy Tuck

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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.

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 83 reviews

Three factors for bulge after Tummy Tuck

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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!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Bulging in lower abdomen

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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

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Swelling after tummy tuck surgery

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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. 

Swelling can take time to resolve.

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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.

Bulging Abdomen

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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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Normal swelling after an abdominoplasty

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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.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.