What is Normal Swelling After a Tummy Tuck?

Question

I am just curious about what is normal swelling and what is the sign of a problem. I had my tummy tuck three days ago. Yesterday when I removed all dressing my stomach was flat and no swelling. By the evening below my belly button and past incision is swollen up like a softball.

Dhaval M. Patel, MD · Answer

Thank you for your question. Being only a few days out of surgery, swelling is going to be normal. However, if it is severe swelling and you are really concerned contact your plastic surgeon so he can better evaluate you. You may be accumulating fluid. You want to make sure whats going on. Best of luck!Dhaval M. Patel Double board certifiedPlastic surgeonHoffman EstatesBarringtonOakbrookChicago

Martin Jugenburg, MD · Answer

While it is normal to have swelling after a tummy tuck, this usually is present immediately after the surgery.  If you have new swelling that appeared 2 days after the surgery, you may be seeing fluid accumulation such as a seroma, or possibly bleeding.  You should let your plastic surgeon know so that he can examine you.

	Sincerely,

	Martin Jugenburg, MD

Ralph R. Garramone, MD · Answer

If you truly have swelling resembling a football below your belly button you should contact your plastic surgeon and plan on being seen.

	There is a normal amount of swelling after an abdominoplasty but this should not affect the overall contour improvement that you noticed soon after surgery.  In my opinion swelling is maximal at about 48 - 72 hours after surgery and will then begin to slowly subside. How much swelling is "normal" will depend on how much surgery was done, whether liposuction was performed and how much, how active you are after will also play a role.

	In general there will be less swelling when you first get up in the morning and more as the day goes on especially if you are more active.  This may go on for as long as 3 months after surgery. A seroma, which is a collection of fluid under the skin , which may have to be drained, will not fluctuate during the day like swelling. 

	Thank you for your question and good luck.

Sugene Kim, MD, FACS · Answer

It is normal to see swelling after tummy tuck; the swelling is more common in the dependent position such as lower abdomen and pubic region. Especially toward the end of day or if you have been active during the day, you would see more swelling. It will take up to 2-3 months for all the swelling/edema to disappear. However, if you see a sudden swelling or persistent swelling, you may want to see your plastic surgeon to rule out hematoma/seroma. Also, follow your plastic surgeon's post-operative instruction in regards to compression garment and activity limitation.

Tom J. Pousti, MD · Answer

Thank you for the question.

As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.

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.

Geoffrey Barnett, MBBS, FRACS (retired) · Answer

Thank you for your enquiry. It would appear that the sudden swelling following removal of your dressings 24 hours previously would indicate that something is amiss.

I would suggest that you contact your plastic surgeon for further assessment as drainage of a haematoma or seroma may be necessary.

You may have been over doing activities and there may be incomplete support of your abdomen during this early healing phase leading to a haematoma or seroma.

Good luck with your recovery.

What is Normal Swelling After a Tummy Tuck?

Answers (6)

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