Roundess in Lower Abdomen 4 Weeks Post Op Tummy Tuck? (photo)

I am 4 weeks post op from a full tummy tuck with muscle repair. Pre-op I was 5'3",108 pounds, 17% body fat, size 0/2, marathon runner/triathlete. My abdomen was very flat, I just had extremely wrinkled and saggy skin from pregnancies and weight loss. Now my lower abdomen is very round and protrudes like I am pregnant. I am at least 3 sizes larger than before surgery. I know I have swelling and its early, but the shape is every concerning because I look much worse now. Will this likely flatten?

Doctor Answers 8

Swelling after tummy tuck

I would recommend returning to your surgeon to make sure you don't have a seroma or fluid collection after surgery.  It can be drained easily in the office, if it is simple post-operative swelling it will gradually improve, continue wearing your abdominal compression garment either way


good luck

Grand Rapids Plastic Surgeon
5.0 out of 5 stars 53 reviews

Lower abdominal swelling after an abdominoplasty

If you have swelling of the lower abdomen this is either soft tissue swelling or a seroma.  In any case you need to be evaluated by your plastic surgeon.  

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

Roundess in Lower Abdomen 4 Weeks Post Op Tummy Tuck?

See your surgeon ASAP to examine you for seroma collection in the inferior areas of the abdomen. Follow up on the findings would be nice. 

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

Roundness of lower abdomen 4 week after Tummy Tuck

It takes several months for the swelling from a tummy tuck to subside. I think that the swelling you are experiencing is normal although it could also be a fluid collection. I recommend following up with your plastic surgeon for examination. 

Leo Lapuerta, MD
Houston Plastic Surgeon
4.2 out of 5 stars 47 reviews

Roundness in lower abdomen 4 weeks after tummy tuck

Swelling in the lower abdomen is common after a tummy tuck.  Your post-operative profile photo, however, is significantly rounder than your pre-operative photo.  Based upon your photographs, I would recommend that you follow-up with your plastic surgeon, to confirm that the contour is due to swelling and not to a fluid accumulation.  Large fluid accumulations, if left untreated, may result in a permanent contour deformity or require surgery to correct.

Good luck.

Craig S. Rock, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Swelling in the abdomen 4 weeks post-tummy tuck?

It is vey common to have swelling in the lower abdomen 4 weeks after a tummy tuck.  This usually will resolve with time.  That being said, your photos are a little troubling because of how much swelling you have.   I recommend you contact your plastic surgeon so that you can be examined and he or she can make sure that you do not have a fluid collection there.  Good luck.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.8 out of 5 stars 133 reviews

Roundess in Lower Abdomen 4 Weeks Post Op Tummy Tuck

Thank you for your question and for the posted photos.

  • Probably the most common cause is not applicable to you, and that is intra-abdominal contents that cannot be compressed. That can happen in overweight patients with unrealistic expectations. 
  • Another, which seems likeliest to me is a fluid collection which if present would need to be aspirated.
  • Swelling of the soft tissues, though this seems a bit much, and
  • Failure of a muscle tightening, but that too makes little sense here. 

I think my best suggestion is that you have a visit with and examination by your surgeon to find an explanation and to offer suggestions for correction.

Thanks and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Swelling after Tummy Tuck?

Thank you for the question and pictures.
It is always 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)  a complete skin redraping  to occur.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 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.