Had Tummy Tuck 27 Days Ago Swelling Never Decreases? (photo)

The wound
healing process following abdominoplasty lasts for over a year.  Most of the swelling resolves in six to eight
weeks, but small amounts of swelling may persist for up to a year.  The procedure inevitably interrupts the
abdominal lymphatic drainage, and this takes time to re-establish itself.  Patients can minimize swelling with
compression garments, massage and limitations on physical activity levels.  It’s important to remember that swelling is a
normal part of wound healing, and should resolve with time.

            Significant swelling four weeks
following abdominoplasty should be evaluated by your plastic surgeon.  In the vast majority of cases, this swelling
is probably normal, but in a small percentage of patients it might represent a
problem.  Seroma formation, low grade
infection and separation of the muscle closure might be possible explanations
for this swelling.  In some cases, a CT
scan may be necessary to resolve this issue. 
If you have concerns about persistent swelling, make sure you discuss
this issue with your plastic surgeon.

Swelling is not uncommon after a tummy tuck and typically lasts quite a while. 80% has resolved by 3 months and the rest takes up to a year to resolve. You have to be patient with the healing process.Enjoy your new look!Sheila Nazarian

More than likely you just have soft tissue swelling.  This can persist for up to 3 months after surgery.  The other possibility is a missed seroma.  If you feel like a water bag then a seroma is present and your plastic surgeon should be able to drain this in the office.

Hi,

  It is possible that the tissue of the upper abdomen had some thickness such that when redraped, it still would maintain some thickness and fluid. 

  Your fluid drainage is quite small in the post op period so the possibility of a seroma always needs to be ruled out.  If your doctor stuck a needle through the lower tissue and did not get any fluid (serum), then it is possible that you have a lot of fluid in the tissue itself.  You will  notice that the swelling is more at night than in the morning.  This is usual for even up to a year as your body builds new vessels to the muscles for drainage of the redraped tissue.

  Be patient.  However, if I am reading this right, you had your surgery 8 months ago.  If this is the case, then you have had a reasonable post op recovery time and it may be that the tissue is actual fat and would need some liposuction to get you the result that you want.

  Discuss this with your doctor and see what your options are at this point and in the future.

I am sorry to hear about your prolonged swelling.   Unfortunately lower abdominal swelling can take up to 3 months to resolve.   It would be helpful to see your before photos to assess where you started.   An ultrasound may be helpful if the swelling increases or does not improve to exclude any seroma pockets.

 

I wish you a safe and healthy recovery.

It can take at least 6 months for tummy tuck swelling to completely go away, and sometimes it can take a year. So since you're only 4 weeks out from surgery, you definitely have swelling.  And since your plastic surgeon was unable to drain any fluid, it's very unlikely that you have a seroma.

I know it's easier said than done, but try to be patient, continue wearing your compression garment, massage your abdomen daily, and keep your appointments with your surgeon. I hope that helps and wish you all the best!

From your photo, it does appear that there is a significant abdominal wall bulge, but this is difficult to see.  You could have postoperative swelling of the tissues, a recurrent seroma or fluid collection or an incomplete correction of the abdomen. Without seeing you pre-op and in person, we cannot tell. Revisit with your surgeon to get a better opinon or re-post more and better quality photos for more insight.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

It is difficult to tell what you undesired contour could be but as the other doctors alluded to, it could simply be swelling fluid (edema).  However one possibility that has not been mentioned is a disruption of your diastasis repair or no facial plication at all.  If you do not trust your surgeon to give you an honest answer, they you may want to request a copy of the operative report which may give some clues as to what was exactly done.

However, my best guess at this point is that your swelling is normal and just takes time to come down to normal.  June 27 is still very recent.  I would not expect your swelling to go down for another 1-2 months.

Thanks for your question and for the attached photo. Without a pre-op photo to compare, it is not easy to guess the cause.

Persistent fullness can be due to 


Incomplete abdominal wall correction (or loss of that correction)

Fluid collection-hematoma (blood) or seroma (fluid)

Incomplete thinning of the lower abdominal skin

Swelling


At this point in time you would do well to see your surgeon again, and if a seroma or hematoma is suspected, another try at aspiration is in order. With the limited information I have, this seems the likeliest. 

Continue with your compression garment and other post-op instructions from your surgeon. 

Thanks and best wishes.

 

 

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.