How Normal is my Tummy Tuck Swelling 4 Months Post-op? (photo)

I'm happy with my result so far, but 4 mo. after, I have a noticable "pudge" above the scarline mid-chest. I know that some of it is swelling, as it's more visible midday. But it's remained constant for 2 months & I'm thinking that as time goes on some of it may remain. It bothers me because when I sit down or look side-profile the "rounding" is pronounced. Of what might remain over time, is it more likely to be fat or excess skin? What can be done with any remaining pudge? How normal is this?

Doctor Answers 10

4-Month Post Op Supra Scar Swelling

From your picture, my guess is that you have both swelling and some fat just above your suture line.  At 4 months, the lymphatic drainage has not totally re-established itself, so some of the pudge above the suture line may be due to swelling, but possibly, there is some fat which can easily be suctioned out as a minor procedure.  I would give it 2 more months and have another consultation with your plastic surgeon. 

You may benefit from liposuction.

This is a common finding when there were no liposuction of the upper abdominal flap during tummy tuck. The tissue from the upper abdomen is thicker(fatter) than the lower abdominal tissue and the step off is the result of discrepancy in the thickness. Liposuction with or without scar revision will help.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Tummy Tuck

Dear patient,
Swelling can persist; however, it may be prudent to consult with your physician to eliminate the possibility of a seroma.

Teanoosh Zadeh, MD, FRCSC
Montreal Plastic Surgeon
5.0 out of 5 stars 4 reviews

Should get more benefit from liposuction.

The most informed opinions would come after a physical exam, however your photo shows a thickness discrepancy between your tissues above and below the scar.  You could wait an additional 4 months or so to be sure all the swelling is gone, but if this remains liposuction will help improve the difference.  This would be true for the mid-chest pudge you spoke of as well.  You would likely find the best results would come with a combined scar revision and skin tightening and some liposuction.  Your plastic surgeon can tell you the best timing for you on this.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 98 reviews

How Normal is my Tummy Tuck Swelling 4 Months Post-op? (photo)

Based only upon the posted photo you need scar revision and additional liposuction. In Seattle see Dr RAND. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Tummy tuck bulge

I recommend that you wait another 2-3 months.  You may need a revision to tighten the skin more in the beltline area, possibly combined with some liposuction.  Only a physical examination can determine for sure what's required.  I would expect something like this if you had a massive weight loss prior to the abdominoplasty but it certainly can be improved.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Tummy tuck revision?

If you have lax skin then you may need a small revision due to rebound laxity.   If there is fatty tissue then liposuction may help

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Swelling after a tummy tuck

Presumably you had massive weight loss and then a tummy tuck.  At 4 months you look pretty normal.  Most of this should be gone aftre 6 months.  Your skin will never be as elastically tight as you might like but just stay close to your plastic surgeon through this follow up.  Good luck.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Tummy Tuck and Swelling?

Thank you for the question and picture.

Overall, based on the limited picture I think you are doing well after tummy tuck surgery. For more specific advice is always best to address your concerns with your plastic surgeon.

Generally speaking, abdominal wall "swelling" after tummy tuck may be related to:

1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary. 
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  a complete skin redraping  to occur.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Swelling largely gone at 4 months


Thank you for the question and photo.  At 4 months after surgery most of the swelling should have subsided.  What you can be noticing is some residual fat above the incision line since the top segment of your abdomen was thicker than your bottom segment.  This can be treated by liposuction or by revision of the scar to thin out the upper segment and possibly also lower the scar.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 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.