7 months post op - is swelling normal at this point in recovery? (photos)

Hello Elinm85,

After examining your photos and considering your description, it appears that the swelling you are experiencing may be due to visceral fat, which is the fat surrounding your organs. This type of fat can contribute to a persistent bulge in the upper abdomen.

While some swelling is normal in the months following surgery, it is uncommon to still experience significant swelling 7 months post-op. Losing weight may indeed help reduce this swelling, as excess fat can contribute to abdominal distension.

If you're struggling to lose weight on your own, there are medications available that can assist with weight loss. Zepbound and Mounjaro are both effective options that your healthcare provider may prescribe to aid in your weight loss journey.

However, it's essential to discuss your concerns with your plastic surgeon to ensure there are no underlying issues contributing to the swelling. They can provide personalized recommendations and monitor your progress to help you achieve your desired results.

Sincerely,
Dr. Katzen

Dear Elinm85,
I understand your concern. 7 months after surgery your results are final. 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 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

Thanks so much for your question,

Each person's body responds differently to surgery, and some individuals may experience prolonged swelling due to variations in healing processes, genetics, and other factors.

Swelling can still be normal at 7 months post-op following a tummy tuck. While most of the significant swelling typically subsides within the first few weeks to months after surgery, it's not uncommon for some residual swelling to persist for several months.

But, based on your photos, it appears that you could benefit from an intensive liposuction procedure targeting the abdomen, waist, and flanks to enhance your body contour. Additionally, considering skin tightening treatments could further enhance your results, achieving even greater improvement.

Sincerely,
Dr. Emmanuel Mallol

I can see in your before and after photos you had a protruding abdomen as result of combination of issues: visceral fat which surgery won’t fix, loose muscle which could be fixed through a thorough muscle repair but the muscle is expandable because it is literally a thin steak

It would be helpful if you would post before photos as well. An examination is needed to see where the swelling is located. If it is internal, surgery does not fix that.

At seven months post op swelling from surgery has resolved. The contour that concerns you is likely from visceral fat as well as abdominal wall laxity. Visceral fat is the fat behind the abdominal wall that surrounds your organs. It can't be addressed by a tummy tuck or liposuction but weight loss should improve it. Abdominal wall laxity can be addressed by the tummy tuck.

At seven months out from surgery your results are final and you are no longer swollen.
The only thing that’s going to change by waiting further is the appearance of your scar which can change for up to 12 to 18 months.
The bulging of your abdomen is most likely due to access, visceral fat.
Weight loss is the only variable that’s going to get you a flat abdomen.
There are four variables that determine what the abdomen looks like.
This is true whether someone has had surgery or not.
The four variables that determine what the abdomen looks like are the following.
1) abdominal skin laxity typically due to weight loss or previous pregnancy.
2) excess subcutaneous fat.
3) muscle separation from previous pregnancy.
Most patients will have muscle separation of their upper and lower abdomen.
How can the upper abdomen stretch without stretching the lower first? The uterus sits in the pelvis, not up by your rib cage.
4) excess visceral or intra-abdominal fat.
To make an accurate assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have the before and after pictures and ask your surgeon to forward the pictures they took.
Most likely you had access visceral fat and this is probably visible on your before pictures.
both muscle separation and excess visceral fat causes the abdominal wall to bulge.
Differentiating between the two isn’t rocket science, and is something all plastic surgeons should be capable of.
Plastic surgeons, who do not understand the difference between visceral, fat and muscle separation may have unpredictable outcomes, and may not be as good at predicting what results will look like.
In reality, most plastic surgery results should be highly predictable and by understanding each patient’s candidacy for the procedure should dictate fairly accurately what the results are going to look like.
Individuals who have excess visceral fat on examination preoperatively are going to have a bulging abdomen, unless they lose weight either before or after the procedure.
There’s no way muscle tightening can hold back on the increased intro, abdominal pressure due to excess visceral fat.
Individuals who carry excess visceral fat should be told that your candidacy for the procedure is limited unless they successfully lose weight first.
There are several ways of differentiating excess visceral fat from muscle separation.
The first is to see what the abdomen looks like when laying on your back.
Individuals with excess visceral fat may still have a slightly bulging abdomen despite gravity, pushing the abdominal wall in towards the back.
Individual do not have excess visceral fat and only have muscle separation will have a concave abdominal wall while laying on their back.
Another way to differentiate is to see how much pressure it takes to press the the abdominal wall to straight position.
A straight abdominal wall should create a B line between your sternum and your pubic bone.
This is the origin and insertion of the abdominal muscles.(rib cage to pelvis).
For example, if you can easily press your abdomen flat and hold it in that position with your non-dominant hand for several minutes then you don’t have access visceral fat.
If it takes a significant amount of pressure to hold your abdominal while in a flat position, and this makes you feel like your abdomen is overly full, and it is hard to take a deep breath than visceral fat is the contributing variable.
Excess visceral fat is the number one reason that patients have a bulging abdomen after a full tummy tuck.
Weight loss will solve your problem.
To understand how much weight you need to lose to get the results you want I suggest starting by losing 5 pounds and then take new pictures.
Continue losing weight until you’re pleased with the shape of your abdominal wall.
Once you get there, you’ll know what weight you need to maintain to have the contour, you desire.
Document what your abdomen looks like at different weights and you know exactly How weight gain or weight loss influences your outcome.
Best,
Mats Hagstrom, MD