Swelling Has Increased After Stopping Compression and Resuming Exercise. What to Do?

6 weeks PO from Full Tummy Tuck with waist lipo. Was advised to stop wearing compression at 6 wks PO and allowed to start running for exercise. Within 24 hours I was very swollen with tight skin. I put my compression garment back on and have not run since. Swelling has not completely subsided 3 days later. Any ideas what is happening?

Doctor Answers 29

Temporary Lymphedema From Exercise Is Common After Tummy Tuck and Liposuction

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You are experiencing postoperative lymphedema of the abdomen and waistline, a very common development after a tummy tuck and liposuction. This is a temporary phenomenon that is caused by impeded lymphatic outflow from the operative sites caused by the lower abdominal incision and the trauma of the liposuction. It was not apparent until you started exercising which pumps extra lymphatic fluid into the area which now has some trouble getting out. It can be alarming to most patients as it is unexpected. In most cases, the swelling will go down by the next day as one is horizontal at night which helps the lymphatic drainage. This mild swelling will be cyclical for a month or two as you are more active and exercise. It is a self-solving problem and is not a cause of long-term concern.

Tummy Tuck and Compression Garment or Binder

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Wearing a compression garment or abdominal binder will help in the early healing after a tummy tuck. It helps compress the tummy and reduces the initial swelling. It also helps the swelling go down over time. In my practice I like to have my patients wear their garment for 2-3 weeks after surgery. Once the last drain is out I recommend that they use the garment for another day or two. Many patients like the feeling and support of wearing the garment and choose to wear it longer. As long as it is fitting well and not chaffing your skin there is nothing wrong with wearing your garment for an extended period of time.

Whether you wear it for 2 weeks or 10 weeks, once you take it off and resume normal activity you may find that your tummy gets a little swollen again. This rebound swelling is normal. After taking a long time off from activity you will increase a little inflammation once you begin moving around again. The swelling will resolve fairly quickly on its own. In fact, the more active you are the faster you will return to normal. Of course, you shouldn't over-do it. But as long as you're comfortable with your activities you can expect things to get back  to normal quickly.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
4.9 out of 5 stars 21 reviews

How long should the patient where a compression garment after a tummy tuck

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Patients who received an abdominoplasty should expect a recovery process that may last anywhere from 2 to 8 months. Factors that may affect how quickly you heal include whether or not liposuction was performed at the same time as your tummy Tuck, the technique that was used for your surgery, and how quickly your body will recover and reestablish arterial, venous, and lymphatic drainage.
In our practice, we always provide the patient with two garments after their surgery. The first garment is the traditional tummy tuck binder that we recommend the patient's use for two weeks after their surgery. After this period, we have the patient use a compression garment that we have designed and that we have made here in Miami. This garment allows for complete and even compression of all the areas that have been treated. We recommend that our patients use this for at least four months after their surgery. Patients tell us that they appreciate the support that the government gives the comfort garment provides by helping minimize their swelling.
At this stage, your best bet is to let your board-certified plastic surgeon know of your concerns so that they may determine if you need to continue wearing the garment or if another process is occurring.

6 weeks after a tummy tuck

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6 weeks is our magic number for healing, it just sounds like you need more time.  Keep the garment on, switch over to something more comfortable that still applies pressure but you can wear clothing comfortably over it such as spanks or spandex.  Limit your fluid and salt intake, that can contribute to edema.  Normally you'd be over this by now, but your body is requesting a little bit more time.  Progressively get back to things and you'll train it to complete normalcy.  Good luck!

Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 125 reviews

Be patient, and see your surgeon if swelling doesn't resolve.

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It’s not unusual for patients who have undergone abdominoplasty and liposuction to experience discomfort and swelling when they resume strenuous physical activity.These procedures have a significant impact on the abdominal wall soft tissue.In many cases, surgical incisions and passage of the liposuction cannula have resulted in damage to blood supply and lymphatic channels.In addition, patients are in the middle of the wound healing process and its associated inflammatory changes.
When patients resume strenuous activity, they maximally stress the lymphatic drainage of the area and in some cases exceed its capacity to adequately remove fluid.This is made worse by the absence of a compression garment.This can lead to the swelling that you describe.
When this situation arises, it’s important to be patient.This is a normal phenomena that occurs with almost every patient who undergoes these procedures.It’s important to go slow at first and listen to your body.It might be helpful to continue using your compression garment and start a low salt diet.In some cases, massage is helpful as well.
If the problem fails to resolve, consultation with your plastic surgeon is appropriate.Under these circumstances, it may be appropriate to obtain a CT scan to rule out an abdominal wall seroma.In the vast majority of patients these studies are negative and patients continue to improve with time.

Swelling increased after my tummy tuck?

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This is actually very common and should resolve on its own.  Swelling actually takes several months to resolve and so you are really very early along the healing period and probably doing fine.  One suggestion would be to increase your protien intake since they tends to have somewhat of a diuretic effect and can also potentially help speed up your healing. 

If you are still experiencing swelling that does not go away in the next few weeks, see your plastic surgeon as there may be other suggestions that he can offer that will help.

I hope that was helpful!

Normal to have some degree of swelling after an abdominoplasty

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At six weeks post abdominoplasty your swelling should be starting to subside.  It generally takes 3 to 6 months for it to completely resolve.  There is no specific time schedule for each individual.  Gentle massage and time is about all you can do at this point. If it seems unusual to you then it is time to consult with your plastic surgeon.  Massage can help, at least temporarily, remove some of the swelling. Think of your scar as a dam.  The fluid is trapped above the level of your scar.  It takes at least 3 months for the lymphatic channels to hook up across the scar and to drain to the lymph nodes in your groin.  If you have a seroma you would feel a water baggy type sensation when you move from side to side.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Abdominal swelling after tummy tuck 6 weeks ago; no compression and restarting exercise.

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This may be only swelling within the tissues (lymphedema) like a saturated sponge, but you should have your surgeon check to see if you have a seroma, which is a collection of fluid in a cavity beneath your skin that did not "stick down" and heal completely, or sheared with your increase in activity and reopened a pseudobursa that has collected blood or lymphatic (serous) fluid.

If the latter is the case, your surgeon may want to aspirate the fluid with a syringe and needle (don't worry, it will be placed through an area that has not recovered sensation yet!) one or more times, or even reinsert a drain for a few days until this area re-adheres and heals.

Though exercise at 6 weeks should in most cases be absolutely fine (I allow my patients to do this), the combination of tummy tuck AND liposuction may make this a slightly more likely possibility.

Schedule a recheck with your doctor as soon as possible if this swelling persists! Good luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Swelling after tummy tuck

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It is normal for the abdominal tissues to swelling variably after surgery especially after being up a long time or after exercise. The tissues are still reactive and inflamed and will tend toward edema since the lymphatic and blood flow is still not normal. Assuming you don't have a seroma or hematoma, I would advise wearing a light compression garment while you run or certainly right after you exercise to counteract the reactive edema.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Swelling after Tummy Tuck and Exercise?

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Thank you for the question. 

It would be best for you to be evaluated by your plastic surgeon to rule out the presence of a fluid accumulation (seroma).

Generally speaking,  tummy tuck surgery involves the interruption of arterial inflow as well as venous/lymphatic outflow. As patients' activity level increases  the abdominal wall flap may have a hard time eliminating fluids from the area. It may take several months to a year for the situation to improve  whereby patients no longer have the increased swelling with increased activity.

I have seen some significant tissue swelling that may be alarming but has always resolved with time.

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.