Do I have a seroma or did my diastasis recti repair fail? (Photos)

Hello,
There are a number of things that could cause the issue you are dealing with. A chronic seroma is likely the most common cause. This could happen after the drains were pulled, and if it did, it would just stay there and cause a hard bulge in the area, and wouldn't go away without surgery to remove the seroma.
If you have gained weight since the surgery it is possible that you gained some fat inside your abdomen which is causing this area to stick out more. I think the least likely thing that happened would be that the diastasis repair failed in that area, as that area is under the lowest tension. If that repair fails it is usually around the belly button, not at the very bottom.
The good news is that a seroma should be easy to diagnose with an ultrasound. I use an ultrasound in my office daily to look for fluid collections, breast implant ruptures, hernias, etc. So some surgeons have them in their office, otherwise you could get one done at an imaging center to look for the seroma. If they do find one the treatment would be to open your tummy tuck incision back up and remove the seroma and the cavity it sits in, because if you just drain it, it will fill back up.
I hope you can figure this out and I hope this information helps you in the process!

Dear 2001Momma,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. Ultrasound can detect seroma. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello and thank you for your question regarding the possibility of a seroma or diastasis recti failure post-tummy tuck.

Based on the provided pictures, it does not seem to be a seroma, nor does it appear that your rectus diastasis repair has failed. However, if you remain concerned, I recommend obtaining an ultrasound to confirm the diagnosis. A seroma is a collection of serous fluid, and while it's unlikely in your case, an ultrasound can provide clarity. If confirmed, it may require drainage.

Regarding your rectus sutures, I don't believe they have torn or weakened. Over time, the abdominal wall muscles may naturally weaken, but this doesn't necessarily mean the sutures have failed. If the ultrasound results are negative and you still have concerns, a revision tummy tuck for further muscle repair may be considered. Some patients, despite lacking excess skin or fat, may require a tummy tuck solely for muscle repair.

Wishing you the best of luck with your recovery journey. I trust this addresses your concerns adequately.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

It's difficult to tell from photos what is causing the rounded abdominal contour. It could be from a chronic seroma, visceral fat, subcutaneous fat, or diastasis repair failure to name a few. I encourage you to visit with your surgeon for an evaluation. Further testing such as an ultrasound may be needed for diagnosis.

An examination can tell what it is. I would suggest going back to your surgeon or seeing another to be examined.