Stomach swelling won't go down, and skin feels too tight. What could this be? (Photos)

Question

Tummy tuck liposuction October 2020, had infection swelling wound seperation at incision . Breast done in May PS relipoed tummy and flank and back by bra, revision breast December 2021 liposuctioned. Flanks and back. Swelling and hardness of belly. Numb skin feels over tight. Had CT january 2022 . Edema in abdomial wall . Colon normal. PS sayin its GI issue .Never had swelling issus in belly before this.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding your abdominal wall feeling tight with your abdominal scan on an abdomen that has had a tummy tuck and several rounds of liposuction. The key elements and the key piece of data is that the CT scan shows edema. That is what you have. Edema is swelling. You can either have swelling above the rectus abdominis muscle or below the rectus abdominus muscle. If the swelling is above the rectus abdominous muscle, I would suggest deep tissue massage as well as lymphatic massage to minimize the swelling. If the swelling is below the muscle, I would suggest you visit a gastric neurologist. At this time I do not see any indications for revision Plastic Surgery. I hope this helps answer your question regarding edema after a tummy tuck and liposuction and continued tightness of abdominal skin. The tightness of the skin is due to the underlying swelling. Thank you and good luck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Daniel Barrett, MD · Answer

Dear Bright785835,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having.  The best person to help diagnose this issue is your plastic surgeon who is most familiar with your medical history, surgical recovery, and test results.  If could potentially be a GI issue even if you didn't experience them before the tummy tuck.  It could be visceral fat, or something else entirely.

Mats Hagstrom, MD (license on probation) · Answer

There are two primary reasons patients may experience upper abdominal bulging after a tummy tuck.
The first is patients who have excess visceral fat causing pressure against the abdominal wall. Muscle tightening is often more effective on the lower abdomen and the increased pressure has to cause a bulging somewhere and it typically shows on the upper abdomen more than on the lower abdomen where muscle tightening can be very effective. When visceral fat is the problem there’s usually a tight sensation and it takes force to press the abdomen flat. For this weight loss is the only treatment that will help.
The second reason for a bulging upper abdomen is patients who are barrel chested. If the chest is round rather than oblong with a sternum that sits significantly in front of the pubic bone abdominal wall will slant back after muscle tightening. The more aggressive the muscle tightening the worse the appearance of upper abdominal bulging. for patients will have this anatomic configuration surgeons can consider backing off on aggressive muscle tightening especially of the lower abdomen. it’s simply a body shape that is less than ideal for this procedure. A tight abdominal wall from surgical muscle tightening will create a beeline between the sternum core front of the rib cage and the pelvis. De more forward the rib cage and sternum sit the more the upper abdomen will bulge after the procedure. My best guess is that in your case you have both conditions and this explains why your results looks the way it does.
These types of results are predictable on individuals who are barrel chested and carry excess visceral fat before surgery.In a perfect world surgeons have sufficient insight, experience and knowledge to recognize which patients will get what type of results and will steer patients expectations accordingly.
Doing second opinion consultations based on a simplistic post on real self isn’t going to get you an accurate assessment.
To get a good assessment you’ll need a formal in person second opinion consultation. whenever doing second opinion consultations patients should come prepared with formal before and after pictures and a copy of your operative report for any previous procedure.
Best,
Mats Hagstrom MD

Stomach swelling won't go down, and skin feels too tight. What could this be? (Photos)

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