Thank you for reaching out with your question about how to differentiate between muscle repair failure and swelling three months after a tummy tuck. It's an important concern, and distinguishing between the two is crucial for appropriate management. To definitively determine if there is muscle repair failure following a tummy tuck, imaging studies such as a CT scan or, ideally, an MRI are recommended. These tests provide detailed images that can help assess the integrity of the muscle repair. Ultrasounds, while useful for certain diagnostic purposes, may not be as reliable for this specific assessment. If you are concerned about the possibility of muscle repair failure, it is essential to consult with your plastic surgeon. They can evaluate your condition and, if necessary, order the appropriate imaging tests. It's worth noting that muscle repair failure is relatively rare, especially considering that most plastic surgeons use permanent sutures for rectus abdominis plication during a tummy tuck. Additionally, surgeons often use multiple sutures in the repair process. Therefore, even if one or two sutures were to fail, the remaining sutures typically provide sufficient support to the muscle. It's also important to consider that swelling can persist for several months following a tummy tuck and can vary in severity from one person to another. This is a normal part of the healing process and usually resolves with time. I hope this information helps clarify the steps you should take to determine the cause of your concerns three months post-tummy tuck. Remember, your surgeon is your best resource for personalized advice and follow-up care. Good luck, and I hope you find the answers and solutions you need for a smooth recovery. Sincerely, Dr. Katzen