Is This Just Simple Swelling After 9 Weeks of Having a Tummy Tuck or is Something Wrong? (photo)

Question

I have a bulge above my incision line after 9 weeks and don't see how my stomach will every look as flat as it was pre-op. When I'm sitting it looks and feels like I have grown a tummy that simply was not there but lying down its flat. My surgeon has said he has done a full abdominal muscle repair and an ultra sound has ruled out a fluid collection. He said I may need lipo and my muscles may have relaxed so i should start to do leg raises. I was very skinny pre-op so I don't understand why?

Tom J. Pousti, MD · Answer

As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.
	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.

Shim Ching, MD · Answer

From your preop photo, you had very little fat to start off with.  I would guess that what you have is mostly swelling from your surgery, which is very common above the incision as the incision affects the normal pathways for drainage of lymphatic fluid.  Compression and massage may help your situation.  Please consult your surgeon and follow his advice. 

	Thank you for your questions.

Kenneth Hughes, MD · Answer

I do not see any skin laxity in the first picture and there is hardly any fat and the abdominal muscles are visible.  I am not even sure how the full tummy tuck could have been performed.  At any rate, swelling after tummy tuck may last for several months.  Continue following up with your plastic surgeon.  Kenneth Hughes, MD Los Angeles, CA

Adam Tattelbaum, MD · Answer

Thanks for your questions and for the photographs.
	 
	I'm glad to know that your surgeon has ruled out a fluid collection because that is certainly a possibility.  Unfortunately, swelling above the incision is quite normal for a few months after surgery.  The scar tissue acts as a wall which traps fluid in the soft tissue above it.  This is not the kind of fluid that you can stick a needle in to drain.  It is more like a swollen bruise. 
	Fortunately, as the scar tissue continues to mature normal connections that let fluid pass through the body tend to open up once again and the swelling goes down.
	I would recommend you continue to follow up with your plastic surgeon.  If he or she agrees I have also found that a compressive garment can help minimize the swelling during the course of the day.
	 
	Best wishes.

Paul Wigoda, MD · Answer

After 9 weeks its possible that you still have some swelling. While you dont mention it, if you have gained some weight, that would be an additional factor. What I am surprised by, though, is why you had a tummy tuck at all. It looks from the front view that you had good muscle tone and minimal laxity of your skin. What were you and the surgeon trying to achieve? At this point, I would wait at least 6 months before considering anything surgical. Start or continue to exercise, let any swelling disappear, and then reasess at 6 months. Best of luck.

Is This Just Simple Swelling After 9 Weeks of Having a Tummy Tuck or is Something Wrong? (photo)

Answers (6)

Answer: Bulge in my tummy after nine weeks.

Answer: Bulge in my tummy after nine weeks.

Answer: Swollen after tummy tuck

Answer: Swollen after tummy tuck

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Is This Just Simple Swelling After 9 Weeks of Having a Tummy Tuck or is Something Wrong? (photo)

Answers (6)

Answer: Bulge in my tummy after nine weeks.

Answer: Bulge in my tummy after nine weeks.

Answer: Swollen after tummy tuck

Answer: Swollen after tummy tuck

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.