Stomach Looks Larger After Tummy Tuck - Is there a problem?

Thanks for your question -

It is difficult to say without an examination. Abdominal bulges that occur after your initial healing can represent several things.
It may be a fluid collection that has occurred after your drains were removed (this could include hematoma or seroma. These will usually resolve on their own but may require drainage. Your description of the area being hard point more towards a hematoma.
It may also represent a separation of your muscle repair. This can be something that may need surgical revision.
It may just be residual swelling within the tissue itself.
Be sure to address your concerns with your plastic surgeon.
I hope this helps.

Hello amalex,

It's understandable that you're concerned about the changes in your upper abdomen following your tummy tuck surgery. There could be various reasons for the swelling and tightness you're experiencing at this stage of your recovery.

One possibility is that fluid may be accumulating in the tissues, even if there isn't a drainable collection present. This swelling can occur as part of the body's natural healing response, similar to how tissue swells when injured. Since tummy tuck surgery can disrupt lymphatic channels, it may take some time for this swelling to resolve. Gentle massage techniques can sometimes help encourage fluid drainage and alleviate swelling.

Another potential factor could be differences in the tightening of the muscle layer during the surgery. Over time, these differences may balance out as your body continues to heal.

It's also possible that a stitch used to secure the muscles together may have torn, contributing to the sensation of tightness. While your surgeon initially ruled out this possibility, it's worth considering as a potential cause.

Given the complexity of the healing process, it's often difficult to pinpoint the exact cause of persistent swelling and tightness. In many cases, these issues may improve on their own with time and conservative measures, such as wearing a girdle and massaging the area as advised by your surgeon.

If the swelling and tightness persist beyond six months post-surgery and significantly impact your comfort and quality of life, it may be necessary to explore further treatment options, which could include additional surgery to address the underlying issue.

Regarding your question about taking an X-ray, imaging studies such as X-rays may not provide useful information in this context. It's best to follow up with your surgeon for further evaluation and guidance based on your specific symptoms and circumstances.

I hope this information helps provide some insight into your situation. Please continue to follow up with your surgeon for ongoing monitoring and support throughout your recovery journey.

Best wishes for a smooth and successful recovery.

Sincerely,
Dr. Katzen

This is an interesting problem. Bulging after surgery in the abdominal area can be due to a number of factors: 1) Fluid collections - these are generally detected as firm distension of the skin, and there is a slosh, or wave effect on palpation. 2) Hernia - this is usually felt as a distinct area of swelling in the abdominal wall, this can be reduced with with manual pressure. The other three factors are fat between skin and muscle (usually this is the fat you can pinch), fat under the muscle (This is usually felt as firm distension of the abdomen), and posture. Since you describe this as firm distension, I am inclined to think it is fat under muscle, or posture. Does the contour change when you stand up straight? I think it is highly unlikely that you have muscle separation or hernia. Maintain a healthy lifestyle, and keep in touch with your surgeon. If you do have a correctable problem I am sure he will sort it out and offer a solution. Best wishes
Matthew C Camp MD