What could this pain & something poking under incision line be? 9 months post-op

Question

I’m currently 9 months post op from a tt started to notice on my right side I feel a pain when bending , working out, or even stretching. I also notice there is something poking out a little under my incision line. My incision is completed healed however I can feel this weird knot under the skin and when I press on it or try to grip it with my thumb and index finger it hurts any idea what it may be and the reason for the pain?

J. Timothy Katzen, MD, FACS · Answer

Dear kikibang1,

I appreciate you reaching out about the post-operative concerns you're experiencing after your tummy tuck. While it's difficult to give a definitive answer without an in-person examination, I can suggest a few possibilities.

The 'knot' under the skin you're describing could be a few things. It might be a suture granuloma, which is an inflammatory reaction to a non-absorbable suture used during the surgery. These can occasionally poke through the skin or cause discomfort. Alternatively, it could be a small area of scar tissue or a localized area of fat necrosis, which can also present as a firm nodule under the skin.

The associated pain, especially with movement, could be due to the localized inflammation around this area or could be related to nerve irritation, especially if the nodule is near a superficial sensory nerve.

However, these are just possible explanations and the only way to get an accurate diagnosis is through a follow-up with your plastic surgeon. They may also suggest imaging tests like an ultrasound if necessary. It's important to get any new or worsening post-operative symptoms checked out, even months after surgery, to rule out any complications and to ensure your well-being.

I hope this helps provide some initial guidance, and I wish you a swift resolution to your concerns.

Sincerely,

Dr. Katzen

Semih Yildiz, MD, FEPOBRAS · Answer

At 9 months after a tummy tuck, a painful knot or poking sensation under the incision could be several things, and it needs an in-person exam by your treating surgeon. Common possibilities include a deep suture knot, scar tissue, fat necrosis, a small area of inflammation, nerve irritation, or less commonly a small fluid collection or hernia.

Pain with bending, exercise, or stretching can happen when scar tissue or a suture is tethered to deeper tissue. If it is a retained or irritated suture, your surgeon may be able to feel it and sometimes remove it in the office or with a small procedure. If there is a deeper lump, imaging such as ultrasound may help identify what it is.

Until you are examined, avoid repeatedly pinching or manipulating the area because that can make it more inflamed. Contact your surgeon for an appointment, especially since this is new pain months after surgery. Seek urgent care sooner if you develop increasing redness, warmth, drainage, fever, rapidly worsening swelling, or severe pain.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about recovery from a tummy tuck.

For specific questions like this and about your recovery in general, it is best to speak directly with your doctor or doctor’s representative – such as his or her nurse, or the physician on call for the practice.

You will likely get many differing opinions from members of the RealSelf Community, but they have not personally seen or examined you. Nobody should know you or your unique set of circumstances better than your doctor.

If you feel you are not being listened to or you are doubting your doctor’s recommendations, then it is certainly within your rights to seek a second opinion and get the advice from another board certified physician.  This should be done through an in-person consultation with a thorough evaluation, including a review of your history, review of all prior treatment and with a physical examination.
Obviously, if you think that you are having a medical emergency or other serious problem, you should call 911 and/or go to your nearest emergency room.

Best Wishes.

Daniel Barrett, MD · Answer

Dear kikibang1,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

Connie Hiers, MD, FACS · Answer

You did not post photos, so your surgeon should be able to tell you what is being pinched. You may have a small vein or nerve being pinched or a small amount of muscle. Go see your surgeon.

Scott C. Lindsay, DO · Answer

Hello and thank you for your question.
Sounds like a suture coming  to the service. Reach out to your surgeon to have him/her take a look. Best wishes!

Jeffrey S. Yager, MD · Answer

Sounds like a permanent suture that has a long tail that is close to the skin. Return to your doctor for a check. If it is in the incision line, it can usually be removed under locl easily. At 9 months, the area is healed and removing the suture will not damage your result.

Ahmad H. Ahmadi, MD · Answer

There are a few things that can cause pain or swelling after tummy tuck surgery.  It is best to check with your surgeon because he has operated on you and will be able to pin down the cause much faster than someone else.

Camille Cash, MD · Answer

The knot you are feeling under your incision may be a suture that is coming to the surface.  This can generally be addressed easily in your surgeon's office.  The pain you are experiencing when bending is not typical and would need to be evaluated by your surgeon.

Mats Hagstrom, MD (license on probation) · Answer

We cannot give you an accurate diagnosis of what’s causing pain from reading your post on this website. It’s not unusual to feel scar tissue and suture material underneath the incision.
Follow up with your provider or schedule second opinion in person consultations with other local board-certified plastic surgeons.
Best,
Mats Hagstrom, MD

What could this pain & something poking under incision line be? 9 months post-op

Answers (10)

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