Hello, and thank you for your question regarding prolonged abdominal swelling and pressure after your tummy tuck surgery. I’m sorry to hear you’re dealing with this — it can be very frustrating when the healing process doesn’t go as expected. Persistent swelling months after a tummy tuck can happen, and there are a few possibilities based on what you’ve described: You could have lymphatic disruption, meaning the surgery altered the natural drainage system in your lower abdomen, causing chronic swelling. There could be residual scar tissue (fibrosis) from the surgery, or scar tissue forming where a seroma may have been, even if it wasn’t fully diagnosed as one. There could still be small, chronic fluid pockets that are too small to detect easily but enough to cause pressure and discomfort. In some cases, the lower abdomen and pubic area can remain congested with fluid due to gravity, especially after aggressive lower abdominal work. Pain during intercourse suggests that the swelling and pressure may be affecting deeper tissues, possibly involving tension or scar tissue pulling in the lower abdomen or pubic region. Liposuction may help, but it’s important to understand that standard liposuction often won't fix chronic swelling if the underlying problem is lymphatic damage or scar tissue. In some cases, surgeons recommend: Lymphatic massage therapy (Manual Lymphatic Drainage, or MLD) to encourage better fluid movement. Ultrasound or MRI imaging to check for hidden fluid collections or deep fibrosis. Revision surgery only if imaging or exams confirm there’s something structural that needs to be released or corrected. Before moving forward with another procedure like liposuction, I would strongly suggest seeking a second opinion with a board-certified plastic surgeon who specializes in tummy tuck revisions or post-surgical complications. They may recommend imaging to get a clearer picture of what’s causing your symptoms. You’ve come too far to live with ongoing discomfort, and you deserve answers — and relief. Wishing you the very best on your continued healing journey. Sincerely, Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS (Certified by the American Board of Plastic Surgery and President of the American Society of Bariatric Plastic Surgeons; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery; Member of the American Society of Plastic Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame) Before moving forward, be sure to review your surgeon’s experience with tummy tuck revisions, look closely at before-and-after photos of similar complex cases, and check patient reviews to ensure you’re in experienced hands.