Why is Abdominal Area Swollen? (photo)

I am 3 months post op and my belly is getting worse! when I sit, my belly is over my jeans and I have a bulge in my upper ab area. I had muscle repair, lipo and TT in December 2012. I've exercised and it just gets worse. It is as if my lower belly bulge is now on top. I still look bad in clothes. Would lipo alone fix this or is my muscle repair not successful?

Doctor Answers 4

Why is Abdominal Area Swollen?

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.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Why is Abdominal Area Swollen

Poorly posted photos but appears as a very conservative TT. Best to obtain in person second opinions from boarded PSs in your city. 

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

Bulging skin after and abdominoplasty

In your first photograph you do not look bad but in the second one with your tight jeans on you seem to have a fair amount of excess skin that is pushing its way up and over the top of your pants.  It is possible that you need a skin revision.  On your first photo there area some small bulges of your upper abdomen that may be treated on a delayed basis by liposuction.  Your plastic surgeon is in the best position to understand the problem and your concerns.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Bulging after tummy tuck

It is hard to totally assess but you certainly appear to be bulging way beyond what I would anticipate.    That is too bad and I feel for you.   There are several possibilities to consider.  1.  Your muscle  repair  may have been inadequate.  2. Your muscle repair may have torn.  3.  Your may have had too conservative a tummy tuck   4.   You may not have had adequate liposuction in the area of you tummy tuck......some doctors resist it.  5.  You may have gained  weight.  6.  You may have excessive salt ingestion (Sodium Chloride = table salt in food or on food.)  7.  You may have some combination of all of the above or some of the above.   I certainly do not like what I see but the photos are limited.  I hope all turns out well for you.  You must go to you doctor and see the doctor in person for a discussion and explanation.  My Best,  Dr C.

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 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.