Swelling Above Incision 40days Post Op - Suggestions? (photo)

My experienced, board certified PS says she has never seen this condition before. I am all pooched out above the incision line but flat below. It was all flat at first, but has gotten worse. She says its not a seroma or fluid she can aspirate. She said it was like the upper skin pulled up rather than the lower skin pulling down or something. She is saying may need to do lipo in a few months. I am sick. Is there anything I can do? Should I see another surgeon for an opinion?

Doctor Answers 10

You will need liposuction and revision

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I would recommend liposuction and revision. The tissue planes of the upper abdomen  were not matched to the lower abdomen and this caused pulling the scar up and step off.The cause of the scar migrating up is the lack of deep plane closure(scarpa's layer).

New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Swelling post TT

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This is not unusal because it is dependent swelling or edema above the incision.Gravity pulls everything down but the lymphatics have been cut and you get this swelling above.i would do pressure heat and massage.It may take soem time for it to go down.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Swelling after abdominoplasty

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I've got a tough question for you:  Have you gained weight in the 40 days after surgery?   Take your preoperative weight and subtract the weight your doctor removed at the time of abdominoplasty.  This should be your current weight.  If you are above this weight , you have gained fat and that fat has collected in the part of the abdominal fat pad that was not removed with the abdominoplasty. 

If this is the case, if you get down to your proper postoperative weight, your contour should correct to the way it was early after surgery. 

Please take a look at my blog on this topic.

If this is not the case, I am stumped unless it is fluid.


Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

What happened to my tummy tuck?

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The uneven contour between skin above and below wound closure can be from difference in thickness of pannus, seroma, hematoma, lymphedema, post surgical edema, or insufficient skin resection.  Either way, it will either resolve spontaneously, or, if it doesn't, can be improved later (wait months).  DON'T panic.  You will be fine, and appear to have a good result.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Swelling post tummy tuck

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When I see this it is usually in a patient who has a much thicker upper abdominal area than in the area above the pubic region.  This often leads to prolonged swelling and sometimes note I said sometimes requires revision.  Since there is often much better appearance after 3 months I would wait.  If you suction too soon you may be creating the reverse situation. 

I would wait until 3 months before doing something to correct this as it may greatly improve without doing anything.  At that time, depending on the situation you may need some touchup lipo or scar revision, all of which can be done under local with little if any downtime.  Be patient.

Swollen incision after tummy tuck

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It doesn't make sense that the incision was all flat at first and has now bunched up above the tummy tuck scar. We would not rely on liposuction to provide a solution, as a better result will come from taking the scar and closure down completely and a re-do of the closure with a proper line up of tissue layers.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Lower abdominal swelling 40 days postoperatively

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You are still early in the healing and inflammation process so don't panic as this could be absolutely normal; that is, if a seroma has been definitively ruled out. I would give this around 6 months to significantly decrease in size though it can take up to a year for this to maximally subside. If it doesn't, there are other options including liposuction.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Swelling following tummy tuck

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Give it time.  It is true that a revision may be needed, but this is by no means certain.  If you get to the three to four month point and the situation is the same or worse, the you will most likely need a revision.  The specific revision depends on the findings at that time.

Good luck.

Michael S. Hopkins, MD (retired)
Albuquerque Plastic Surgeon

Swelling Above Incision 40days Post Op - Suggestions? (photo)

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Yes see another few boarded PSs in your area. From your posted photos there is an issue of uneven suture depth alignment. 

Swelling after Tummy Tuck?

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 Thank you for the question and pictures.

I have seen  (on occasion) significant swelling of the subcutaneous tissues ( similar to yours at 40 days postop). The swelling does resolve but takes months to do so. As long as your plastic surgeon is following you closely and has ruled out seroma,  I suggest continued patience;  is very likely that you will see very gradual improvement and back to the “flat” result that you initially saw.

I hope this helps.

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.