Can Swelling Remain in the Upper Abdomen 4 Months Post Full Tummy Tuck? (photo)

When your abdomen is fairly flat in the morning, then more swollen later in the day, the cause is usually just soft tissue swelling.  This can take many months to completely resolve and is often more noticeable in thinner patients because a little swelling is more easily seen in thin tissue.  I would recommend that you see your plastic surgeon again for follow-up.

Hello,

Thank you for the question and the photos.  Very thin patients can show swelling for quite some time.  You may want to continue wearing some type of compression.  If the amount of roundness that you are seeing at the end of the day is improving we can assume that it is swelling.  If the amount of roundness by the end of the day is stable we may have to entertain the idea that it is a abdominal muscle issue.  Your plastic surgeon can help you evlauate this.  You can also take weekly photos to prove to yourself what is and is not changing.

All the best,

Dr. Remus Repta

The fluctuation in size and appearance based on time of day is more indicative of swelling as a cause. At 4 months post tummy tuck, this is not an uncommon occurrence. It can take up to a year for this issue to resolve. Nevertheless, you may want to have your plastic surgeon evaluate you if you haven't been seen recently.

Thank you for the question and pictures.

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

Generally, 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.

If  muscle plication  separation has occurred it can usually be diagnosed on physical examination.  You may notice increased bulging of this area when you are bent over/flexed  or coughing.

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.