Can Being Premenstrual Contribute to Significant Swelling While Recovering from Tummytuck?

I am 4 weeks post op today and have noticed that my midsection has begun to swell quite a bit. No "water bed" motion except in my mons area. I was pretty freaked out by it today, but then realized I'm about a week from starting my period. Would normal premenstrual water retention be amplified by tummy tuck recovery?

Doctor Answers 4

Tummy Tuck

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You are very observant and “yes” this can affect your retention.  Eating out at very salty restaurants can also cause some retention of fluid.  Expect your abdomen to go down in size after your period resolves.

Premenstrual swelling

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The swelling after a TT last for about 6 month, sometimes longer. Flucuations can be seen after more than usual physical activity and ceretainly menstrual hormone changes, but if you see a "water bed" motion in your mons area you may have a seroma that should be drained,  I suggest you see your surgeon in the next few days and have it checked out.

Tummy Tuck and Swelling?

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Watery swelling after a conventional tummy tuck is common. It may, or may not, be related to your cycle. prior to 2010 I did conventional (drain) tummy tiuks. Since then I switched to no drain tummy tucks. this new method is called progressive tension abdominoplasty. I haven't had a seroma (watery collection) since, and my patients are telling me they have no pain! This surgery  approach eliminates the so called "dead space," it may be the end of seromas (watery swelling) after tummy tucks. It maybe too soon to tell.

Swelling 4 weeks after tummy tuck could also be a seroma.

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Premenstrual swelling is certainly "amplified" by having had recent surgery, and just as each woman has a different degree of swelling or fluid retention with her period as compared to any other woman, so can the effects of surgery on fluid retention in the tissues that were operated on, as well as the rest of the body.

However, there are two types of swelling to be aware of, as one requires nothing but time, healing, and regrowth of normal lymphatics (edema as a result of surgical "third spacing" and generalized lymphedema--which would be like water in a fully-absorbed sponge). The other type of fluid retention is a seroma, which is a water-balloon-like collection of fluid beneath the not-yet-adherent skin flaps. This type of fluid needs to be drained, aspirated with a syringe and needle (through a numb area), or if persistent or neglected, surgically removed and re-closed with sutures. While the last option is rare, it IS another operation that neither the patient nor the surgeon really want to have to endure.

The "water-bed" motion in the mons area is a pretty good description of a seroma low in the tummy tuck area, so you need to see your surgeon and see if aspiration is needed (this may need to be done a couple of times) to help this psuedobursa under the skin heal shut, and eliminating the need for later  psuedobursectomy (surgical removal of the cavity and suturing it closed, as described above).

You didn't say when your drain was removed or when you saw your surgeon last, but you should see him/her again soon to have this checked out. Not an emergency, but something best tended to promptly! Good luck!

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