Is this swelling or fat? (Tummy tuck)

Question

Im 3 weeks post op tummy tuck. Is the bulge I have on the lower abdomen below my belly button just swelling, or is this fat???

Martin Jugenburg, MD · Answer

Your body will continue to change for months after your surgery and at this stage there is still swelling that is going on.  You may not end up with complete flatness, but it should continue to change and flatten.

Shayne Webb, MD · Answer

At three weeks, there is still some degree of swelling due to surgical tissue trauma and due to decreased lymphatic drainage.  Give this several months before you lose hope.  Best wishes.

John Michael Thomassen, MD · Answer

At 3 weeks you are still swollen following an abdominoplasty.  Give it 3-4 months and follow up closely with your surgeon to ensure there is no fluid under your skin flap.

Hampton A. Howell, MD · Answer

It's difficult to say for sure, without knowing what you looked like before the surgery as well as immediately after the surgery.  It is very common to have swelling after a Tummy Tuck.  That is typically more prominent in the first few weeks, tapering off over 2-3 months.  You are still very early on in the whole healing process, and should expect changes, including improvements in swelling over the next few months.  There are also other possible causes, though, which can include fluid collections, residual fatty tissue, the structure of the underlying muscles, constipation, etc.  Keep close follow up with your surgeon to guide you through the healing and recovery process.  Take care.

Stephen M. Davis, MD, FACS · Answer

As general rule: it takes 6 weeks to maximize our scar production, your at 3 weeks. Typically when tissue have to heal together it take 10-14 days just for the blood vessels to start re-connecting, your at 21 days, it takes12-18 months for the scar to improve as much as they ever will, your at 3 weeks.Be patient, time is your friend, continue wearing your compression garment and follow your Board Certified Plastic Surgeons instructions carefully and completely. I would exprect that you should do very well. As always if you have any questions or concerns contact you Plastic Surgeon. Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Douglas Taranow, DO, FACOS · Answer

Good question and thanks for posting photos to evaluate too.Swelling after an abdominoplasty (tummy tuck) can last for months.  Your abdomen may be flat in the morning, and then swollen at the end of the day.  You may also notice an unusual amount of swelling right around your menstral cycle for the first few months post op.  Another possibility may be residual fluid under the abdominal flap called a seroma.  This can be easily drained in the office with local (novocaine or lidocaine) anesthesia.  The final possibility is it may be fat that was located under the skin above the belly button that was pulled down during a normal tummy tuck.  The last one would require liposcution several months later.Best of luck.Dr. T

Remus Repta, MD · Answer

Dear lucky lady,At three weeks following a tummy tuck, swelling is certainly still present especially in the lower abdominal area.  A before photo would be helpful to determine the amount of fat present before surgery.  In general, lower abdominal fullness after a tummy tuck can be caused by several factors including:hematoma/seroma/pseudobursaexcess fatswelling (edema)loose abdominal wallMy gut tells me that your fullness is likely from swelling and some residual fat.  However, only a physical exam and evaluation of your before photo could determine this with certainty.All the best,Dr. Remus Repta

Tom J. Pousti, MD · Answer

“Swelling” 3 weeks after tummy tuck surgery may or may not be normal; it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.   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)  for complete skin redraping  to occur.
 Again, let your plastic surgeon know about the questions/concerns you have. Best wishes.

Heather J. Furnas, MD · Answer

You should discuss that with your plastic surgeon who will have an idea of what you looked like before surgery.In my practice my tummy tuck patients take 3 to 6 months to see their swelling resolve. I ask them to wear a support garment for the first 6 weeks to help with the swelling.Any procedure that involves a large surface area inside the body requires extra blood supply to that area during the healing process. Blood leaks fluid into the tissues, resulting inswelling. Swelling is a normal part of the healing process. Click on the link below to see a tummy tuck patient after all the swelling has resolved.

Christine Sullivan, MD (retired) · Answer

At The Sullivan Centre in Columbus, Ohio I ask my patients to wait months prior to seeing their final result. You are still recovering. When in doubt please contact your board certified plastic surgeon. It is important that your concerns be addressed by your surgeon.  Best wishes!

Is this swelling or fat? (Tummy tuck)

Answers (10)

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