3 years post tummy tuck. Still swelling and "shelf" appearance. Should I have a revision? Is this scar tissue? (Photo)

Hello,It isn't 'lymph', or edema. It's fat sitting above a scar that is contracted down towards the deep tissue (abdominal muscles). You are a great candidate for high definition liposuction, and if you want, advancement of your abdominoplasty scar downward. Go visit a few ABPS certified/ASAPS member surgeons who specialize in body contouring surgery. Best of luck!

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question and providing photos. I find it unusual for you to be having that much swelling 3 years post operative. It would be helpful to post before pictures. It is also difficult to fully answer without the benefit of a physical exam. I do not believe the massage therapist theory is correct. It would also be helpful to know if you have had any weight changes or lifestyle changes. My best advice is to discuss your concerns with your PS. Best of luck

Dear LadyL22,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It is not typical to experience swelling three years after a tummy tuck. I encourage you to visit with your surgeon to determine what may be occurring. If excess fat is present you can consider liposuction. If the swelling occurs after eating it may be GI related and a visit to a specialist may help.

and advise, though well intentioned, simply wrong.  The body is an amazing organism and there are plenty of ways for lymph to exit your tummy flap.   Your photos do not show any 'ledge' but if you do have marked changes, you should take photos and see your surgeon to figure out if anything can be done for that or if a revision is warranted.

Hi dear, thank you for your question.It is hard to give you a proper assessment without first seeing you in person but this issue shouldn't be happening if it was performed properly, however a revision as you may know would be the perfect solution for you. I recommend consulting a board certified plastic surgery for a revision and discuss which options are better for you. Massages won't make that bump disappear as it is an internal matter.Hope this helps,Dr. Jimenez Toribio Plastic and Reconstructive Surgeon.