Swollen or Fat Tissue on Top of my Stitches, is This Normal?

Question

I had 2 c-section 9 and 5 years ago. I'm 5'0" 105 lbs (lost 7lbs after 2 months surgery).I had a mini tt and body jet lipo(middle;lower abdomen&love handle) done 5 weeks ago. There was a lot of swelling that occured after the drains came out (1 day). There is still quite a bit of swelling and I feel my skin strecth inside my stomach. This swelling seems to be causing a lip or hang over the incision. I am afraid this is going to remain permanent and not heal to a flat stomach. Is this normal?

Richard H. Tholen, MD, FACS · Answer

Thanks for supplying the photos; they help me see what is going on. The unfortunate reality is that while your healing appears normal for this point in your recovery, your result will leave you with residual loose skin, a "mini" scar that is scarcely shorter than a "full" tummy tuck scar, and with you (correctly) questioning if you should have undergone a full tummy tuck without the abdominal liposuction.

	I believe you should have undergone a full tummy tuck, liposuction of the hip rolls (love handles), muscle sheath plication from breast bone to pubic bone, umbilical transposition, and sub-Scarpa's direct fat excision. This would have likely cost the same or less than you spent (at least in our facility), and yielded (I believe) substantially better results. I don't tell you this to make you dissatisfied with your own surgeon or result, but rather to educate other prospective patients who may be reading this answer, all of whom, like you, get seduced with tales of "shorter" scars, no "bulls-eye" umbilical scar (there IS a better way), "lower" cost, and then end up spending the "saved" cash on liposuction of what SHOULD have been COMPLETELY removed with a "standard" tummy tuck!

	Drain removal at 1 day is one tip-off that this may not have been a carefully thought-out procedure, since there is considerable fluid within the tissues with body jet liposuction, as well as a potential cavity in the area of skin excision that cannot "stick down" in just one day. You have subcutaneous blood and fluid that has turned into scar fibrosis (that is difficult if not impossible to remove with subsequent liposuction of any type) that will soften to a degree over 6-12 months, but will not "go away." And, unless your "mini" tuck included muscle sheath plication from the umbilicus to the pubis (doubtful, since liposuction was performed, this tissue layer was not lifted up), your abdominal wall is still loose and stretched by your 2 pregnancies. Without this looseness being sutured tighter, your abdomen cannot become flat by simply emptying-out the skin  and taking a small skin ellipse out to try to tighten it a bit.

	Let things settle for 6-12 months, keep your scar out of ultraviolet exposure (or it will turn brown permanently) until faded maximally, and see one or more experienced ABPS-certified plastic surgeons for advice on the next step if you remain dissatisfied. Best wishes!

Tom J. Pousti, MD · Answer

Unfortunately, the results of your surgery may be &ldquo;normal&rdquo; given the type of procedure that was performed. Based on your history, I think expectations for a &ldquo;flat stomach&rdquo; was too high with the procedure formed. You should follow up with your surgeon for closer examination and recommendations at this point.

	In general the &ldquo;mini  tummy tuck&rdquo; is a very limited operation that I very rarely perform  (very few patients are good candidates for this procedure). Most patients seeking abdominal wall surgery have significant amount of excess skin along with spreading of the rectus muscles (diastasis). These issues are not treated successfully without a full  abdominoplasty.

	 

	In my practice, it is more common that we treat patients who have had misguided mini  tummy tuck surgery (with full tummy tuck revision surgery).

	Best wishes.

Swollen or Fat Tissue on Top of my Stitches, is This Normal?

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Swollen or Fat Tissue on Top of my Stitches, is This Normal?

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