6 months post op - what could be causing puffiness and hardness in abdomen? (photos)

Hello, thank you for your recent question and photos. Your results look great for 6 mo post op. You can still have swelling for up to a year post op, especially since you are working out 4-5 times a week. The hard firmness you are feeling is the muscle repair and swelling and inflammation to that area. It will get softer and more relaxed with time. Best of luck !

Dear Fabulous796094,
based on your photos, your results look great. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello @Fabulous796094, thank you for your question. It is important to take into account several aspects among which is the surgical technique applied, and to evaluate if there is something else at a systemic level. Remember that a surgery has a process for healing that can take to a year. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Without a physical examination, and a full understanding of what was done at your surgery, it can be difficult to pinpoint exactly what could be causing your discomfort. Some of the standard reasons patients can have pain after abdominoplasty are: scarring if liposuction was done in the area, discomfort from sutures used to repair your diastasis, a seroma pocket in the area. The puffiness that you’re feeling up top may be some residual tissue not removed if you had liposuction. You should contact your plastic surgeon and voice your concerns as that person would have the best idea as to exactly what was done during your procedure. Best wishes.

There are a couple of things that might be happening, including still be swollen. Go back to your surgeon and be examined and discuss your concerns.

It sounds as if you have concerns about your results as well as discomfort you are experiencing. The best person to advise you is your surgeon. She/He is most familiar with the details of your surgery and how you've been progressing through recovery.

Based on only the 2 posted photos in limited views and in clothing very hard to advise. My guess is you have excess a skin fat that needs Lipo with abdominal etching. Fee $6,000. Best to virtual consult with to determine exact issues.

Since i do not see what you refer to as puffiness or any swelling in the upper abdomen, i suspect what you are feeling is normal. What most surgeons do in an abdominoplasty is to tighten the lax muscles with "corset" sutures (as well as remove excess skin and fat). Most of us run a suture from the public bone up to the end of the sternum or breast bone. If you have a lot of fat inside the abdomen, not just outside on the belly wall, then it will become pretty tight in there as we cannot safely remove intraabdominal fat. You won't be as aware of the tightness lower in the belly because a) the pelvic bones prevent any expansion down there but in the upper abdomen the tightness will push on the diaphragm or breathing muscles and b) the lower abdomen is much more numb than the upper for longer since the nerves regrow a little faster for top than bottom. Think of it like wearing an internal girdle 24/7. Most of us are happy to take it off after a few hours once we get home. The good news is this usually lessens with time as things stretch and you also get more used to it. You want that belly tight like it used to be; that was the whole reason for this surgery. Some women use that puffy feeling to signal when they should stop eating and can lose weight easier after abdominoplasty. But try not to worry, your result looks awesome.

Your post does not make clear if it’s the aesthetic outcome your concern about or pain after the procedure or possibly both. To make an accurate assessment on the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took. That’s also the correct person to talk to about the outcome of your procedure. it looks like your subcutaneous fat layer is thin in your waist and thickens up on your back by your bra. I’m guessing you had liposuction in conjunction with the procedure and the back was not included. This may also be true for the upper abdomen. Some firmness is common after this procedure. For some people, it’s simply the ability to feel their abdominal wall after having their subcutaneous fat layered and skin pulled tight and made thin. There’s also a certain amount of scar tissue that forms, but this typically softens up over time. A tummy tuck is a pretty major operation and it does leave your body feeling different. Eventually most people get used to it as being the new normal.
I suggest you follow up with your provider if you have concerns about the outcome of the procedure or schedule if you in person second opinion consultations. For second opinion consultations I recommend patience come prepared to bring with them a complete set of proper before and after pictures and a copy of your operative report. These are all available from your current providers office if you request them.
Best,
Mats Hagstrom, MD