4 Weeks Post-Op Tummy Tuck With Lipo My Stomach Still Shows a Bulge and is Loose when I Sleep Side Ways, What Can I Do? (Photos)

I had total abdominoplasty with lipo 4 weeks back.My stomach still shows a bulge and loose stomach when i sleep side ways.Doc could not do lipo on upper stomach fearing infection and has asked me to try after 6 months.I am unhappy with this bulge.Is it swelling and will my stomach get flatter after 3 months.I have lost only 1" waisline.

Doctor Answers 5

Bulge after tummy tuck

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The photos are helpful, but to really know what is going on, you need to be examined, and if this bulging has increased since surgery, possibly an ultrasound or other imaging procedure. Present your concerns to your surgeon.

San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Bulging After a Tummy Tuck

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While you are one month out from a tummy tuck and liposuction, there is still a fair amount of swelling that remains at this point.  Much of the swelling is related to edema of the tissue above the muscle and some is likely related to intraabdominal contents (those structures inside your abdomen).  With time you should notice that the swelling continues to subside.  After three months you will have a very good idea where your results are and then you should speak with your plastic surgeon to determine if anything else needs to be done.  Best Wishes!

Louis DeLuca, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 58 reviews

Bulge and loose skin after tummy tuck

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Thanks for sharing your pre and post-op photos.  Based on your photos, I think your bulge may be due to (1) intrabdominal content (your intestines and fat from your abdominal cavity) pushing outward, (2) fatty layer outside of your abdominal cavity,  (3) swelling.  You are only one month post tummy tuck.  You can wait another month or two to see how your swelling subsides.  Then, talk with your plastic surgeon and see whether you can get a liposuction vs. exercising to lose fat from your intra-abdominal cavity.  Talk with your plastic surgeon to share your concerns.

Swelling after Tummy Tuck?

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Thank you for the question.

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

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.
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.

Probably Intrabdominal Fat

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Based on your photos, I suspect the the problem is a combination of intrabdominal fat,  some subcutaneous fat and swelling. The swelling will improve with time and the subcutaneous fat can be suctioned as your surgeon recommends. However to get the ideal result, you have to do your part to lose the intrabdominal fat by diet and exercise. The situation will be much clearer in 3-6 months. BTW, I think you have a pretty good early result. Good Luck!

Brian Klink, MD
Vacaville Plastic Surgeon
5.0 out of 5 stars 100 reviews

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.