Can't stand straight after 1 month. Is this normal? (Photo)

Question

I had a tummy tuck with lipo one month ago (4 weeks). I had a seroma that my ps drained (60 cc) 2 weeks ago. I'm still hunched over. My tummy is still so swollen & tight, I feel like I'll never walk straight. I've been wearing my compression garment faithfully & he prescribed me a muscle relaxer to help. I get muscle spasms in the middle of the night & wake up stiff with my arms & legs asleep. Is this normal? Have you ever had a patient that still couldn't stand up straight after a month?

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns with us.
At this point (1 month post-po) the swelling is normal.
To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts.
I usually recommend to my patients to start walking straight after the third week slowly without causing tension to avoid unnecessary risks.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

John Michael Thomassen, MD · Answer

You may still have a seroma accumulating and possibly a pseudocyst or a layer of scar tissue around the seroma.  This can cause tightness that affects your posture.  Repeated seroma aspirations may resolve the fluid but if you still have the scar tissue, the tightness may persists.  Sometimes removing this scar tissue surgically needs to be performed.

Christian Subbio, MD · Answer

usually the inability to stand upright lasts only a week or two. One month out is uncommon, but I've never heard of this being permanent. The tissues always stretch out, it's just a matter of time. See your surgeon so he/she can evaluate you in person and determine if the seroma is back and needing drainage. Keep massaging, slowly stretch more each day, and it will get there. good luck!Dr. Subbio

Jason Hess, MD · Answer

It is unusual to be unable to stand straight after one month.  It is not unusual to be unable to stand straight for 2 weeks.  I generally advise my patients that the first 3 days following surgery are, by far, the worst.  After 2 weeks, pain, discomfort, and posture improve.  A seroma is the most common complication following abdominoplasty.Seromas are sometimes drained, but will often resolve on their own.  I would follow up with your physician and discuss your results.  Most committed physicians are also committed to their results. Good luck!!

Jeffrey M. Darrow, MD · Answer

You have several reasons for you not being able to stand up straight yet.  1)  The TT itself, especially if your muscles were placed back together,  can restrict your ability to stand up as doing so can stretch the muscle repair and the skin of the abdomen.  It will be uncomfortable for a time.   Both will eventually relax.  2)  Your seroma may not be fully resolved so follow up with your surgeon to be sure it is fully treated.  An Ultrasound may help to see if any is left.   If not resolved, the seroma itself can cause discomfort and inhibit straight posture.  Once it is fully resolved, the tissue where it was will be firm and stiff for 1-2 months as it heals.  Again, this will also resolve.  Follow up with your surgeon so both issues are fully resolved and if some muscle relaxants may help and a gentle stretching and masaging regiment may also be beneficial.  Good luck.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question and photo. Sorry to hear you aren't feeling well. Based on the history provided, there is a good chance you have another fluid collection. You should contact your plastic surgeon for arranging aspiration of the fluid. Compression garments are helpful following drainage, but seromas typically require several aspirations. Hope this helps and good luck!

Robert Brueck, MD · Answer

This is somewhat unusual.Usually my patients are standing upright in a day or two.I would follow up carefully with your plastic surgeon.It sounds as if your problem is muscle spasms.

Craig Harrison, MD · Answer

Sorry about your slower than usual recovery.  Every patient is unique in their post op course.  Your surgeon can encourage more stretching exercises and get you more upright soon.  I tell my tummy tuck patients to expect lower abdominal swelling to persist for 4 months.  The toughest portion of your recovery is in the rear view mirror.  Congratulations and best wishes.

Darryl J. Blinski, MD · Answer

Does sound unusual but more photos or in person examinations are needed to rule out serums. Was a drain used initially? Maybe a scan might shed some light if there is an issue....

Anh Lee, MD, FACS · Answer

It looks like your seroma may have returned and it would be best to return to your PS to see if any more fluid can be pulled out.  Most patients are able to walk straight at this point however you have had a setback with the seroma so it may be awhile before everything is settle down.

Can't stand straight after 1 month. Is this normal? (Photo)

Answers (11)

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