Why Are my Legs Swollen Weeks After Tummy Tuck?

Question

I had a tummy tuck May 23rd and am still pretty swollen, but really swollen in my legs (upper thighs).  What's going on? And I think I might be losing hair.  HELP

Richard J. Bruneteau, MD · Answer

Persistent lower extremity swelling is unusual following
abdominoplasty surgery and should be investigated vigorously whenever it
occurs. Although it’s not unusual for patients to retain fluid in the immediate
post-operative period, this usually resolves in the first 2 weeks following
surgery.Late
swelling following abdominoplasty can occur for a variety of reasons. Many of
these causes are potentially serious and could represent life threatening conditions.
For these reasons it’s important to determine the cause of this problem as soon
as possible.This
type of swelling can be caused by deep venous thrombosis of the lower
extremities. This problem can occur following surgery and involves the formation
of blood clots in the lower extremity veins. These blood clots have the
potential to break free and go to the lungs where they can cause life
threatening situations.This
type of swelling can be related to lower extremity lymphedema. This diagnosis
can result in chronic disability and the need for lymphatic massage. This may
be related to disruption of the normal lymphatic channels during surgery.In some
cases, this type of swelling may be unrelated to surgery. This type of swelling
could be related to congestive heart failure. In some cases, drugs that are
used to manage hypertension such as amylodipine can cause peripheral swelling.When
lower extremity swelling occurs late in the post-operative period, it should be
investigated aggressively. The treatment will depend entirely upon the
causative factors. It’s therefore important to consult your plastic surgeon as
soon as possible.

J. Timothy Katzen, MD, FACS · Answer

Dear Crystal E,

Thank you for reaching out. Swelling after a tummy tuck, also known as abdominoplasty, is a common occurrence and can persist for several weeks to months as your body continues to heal and adjust.

While it's normal to experience swelling in the abdominal area following surgery, swelling in the legs, particularly the upper thighs, may be less common but can occur for several reasons:

Fluid Redistribution: During surgery, fluids are often administered intravenously to maintain hydration and manage blood pressure. After the procedure, your body may redistribute these fluids, leading to swelling in other areas, including the legs.

Limited Mobility: After surgery, patients often have reduced mobility and may spend more time resting or lying down. Prolonged periods of immobility can contribute to fluid accumulation in the lower extremities, leading to swelling.

Lymphatic System Disruption: Surgery can temporarily disrupt the normal function of the lymphatic system, which plays a crucial role in fluid balance and immune function. Swelling in the legs may occur if the lymphatic system is temporarily impaired.

Medication Side Effects: Certain medications prescribed after surgery, such as pain relievers or antibiotics, can cause side effects, including swelling or fluid retention.

Regarding your concern about hair loss, it's essential to discuss any unusual symptoms or changes with your healthcare provider, as they can provide personalized guidance and address your concerns appropriately.

I recommend contacting your plastic surgeon to discuss your symptoms and receive further evaluation. They can assess your condition, provide recommendations for managing swelling, and address any potential concerns about hair loss.

Best wishes for your continued recovery,

Dr. Katzen
Plastic Surgeon

Jerome Edelstein, MD · Answer

I recommend you see your surgeon as soon as you can regarding the swelling in your legs. Have you been leisurely walking around during your recovery? This can help ease the swelling and keep your circulation going. Swelling increases when you aren't active and lie around in bed all day.

Paul Vitenas, Jr., MD · Answer

It is unusual to have swollen lower extremities 5 weeks following an abdominoplasty. This condition could be caused by a blood clot in the legs or pelvis or blockage of lymphatic drainage. In the early postop days walking should help relieve swelling in the lower extremities. But if it persists then evaluation needs to be undertaken to determine the best method of treatment.

Jaime Perez, MD · Answer

It is quite unusual for your legs to be swollen after a tummy tuck. I would highly recommend you contact your surgeon immediatly as this can be a serious situation such as clotting. Did you wear your compression stocking post surgery? Walking is also important post surgery to keep the blood flowing in your legs... Best of luck to you.

Rod J. Rohrich, MD · Answer

One of the key elements in preventing leg swelling is to walk frequently (6-8 times per week for 10-15 minutes each time) and not lay in a dependent manner (have your legs elevated). Also, if you have had liposuction and you’re wearing a garment it is good to take the garment off for at least 24-48 hours. If you have asymmetric leg swelling or pain in your calf or thigh then you need to have it evaluated as soon as possible with your doctor to rule out a deep venous thrombosis (DVT).

Bryan Curtis, MD · Answer

Swelling in the legs weeks after a tummy tuck procedure can occur for several reasons:1. Fluid Retention: After surgery, the body may retain fluids as part of the healing process. This can lead to swelling not only in the abdominal area but also in other parts of the body, including the legs.2. Limited Mobility: During the initial recovery period, patients may have limited mobility and spend more time resting or lying down. Prolonged periods of inactivity can contribute to fluid buildup in the legs and feet.3. Surgical Technique: The surgical technique used during the tummy tuck procedure can affect fluid drainage and circulation in the body. In some cases, this may lead to temporary swelling in areas distant from the surgical site, such as the legs.4. Lymphatic System Disruption: Surgery can disrupt the normal functioning of the lymphatic system, which is responsible for draining excess fluids from the body. If the lymphatic system is not functioning optimally, fluid buildup and swelling can occur.5. Medications: Some medications prescribed after surgery, such as painkillers or blood thinners, may contribute to swelling as a side effect.It's important to discuss any concerns about swelling with your plastic surgeon, as they can provide guidance and recommendations based on your specific situation. Additionally, following post-operative care instructions, staying hydrated, and engaging in gentle movement or light exercise as advised by your plastic surgeon can help promote proper circulation and reduce swelling over time.

Pat Pazmino, MD, FACS · Answer

Swelling in the lower extremities after a tummy tuck is possible.
The most important thing is to have your plastic surgeon evaluate you to make sure that the swelling is not dangerous or caused by clots in your leg. This is especially important if the swelling is below the knee.
If your surgeon suspects a clot, ultrasound and blood work may need to be done immediately. 
If a clot is not responsible, he or she may recommend special garments, a change in your diet or medication.
Do not delay in seeing your surgeon. Both of you will be glad that you did.

Best-
Pat Pazmino, MD, FACS
Board Certified, American Board of Plastic Surgery
MIAMI AESTHETIC SURGERY
305-576-3443

Tracy Pfeifer, MD · Answer

You want to make sure that both your leg veins and your lymphatic system are working properly. I suspect that because your thighs are swollen, that this is probably a lymphatic issue. It can happen that your superficial lymphatic system is somewhat compromised after the surgery; some people also have a lymphatic system that is not 100% and they notice a difference after surgery. I agree the best thing to do is to consult a vascular surgeon who can examine you and make sure that everything is OK. As for hair loss, this could be for many different reasons. Consult a dermatologist who treats hair loss. Hope this helps.

Steven Wallach, MD · Answer

It is extremely unusual to have leg swelling almost 9 months after a tummy tuck. Swelling may be due to obstruction of your lymphatics or from clots in the legs Either way, you should be examined by your doctor, and maybe by a vascular surgeon.

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