Breathing Problems and GERD After Tummy Tuck

You did not give any details about your body habitus prior to surgery. It can happen in fairly large people with a protruding abdomen, that when they undergo an abdominoplasty and make the abdomen flat, the intra-abdominal contents are squeezed into a smaller space. This in turn pushes against the diaphragm, and thus limits expansion of the lower lung segments.
I lay my patients down in the supine position on my examination table and examine them that way as well. If their abdomen does not go flat, I tell them that they are not an ideal candidate for a tummy tuck. If I would tighten their abdominal wall to make it flat (sometimes this is not possible), they would end up with the symptoms you are experiencing. For this type of patient, I recommend weight loss with diet and excersise program prior to surgery or if they are morbidly obese, lap band or gastric bypass prior to an abdominoplasty.

Thank you for your question regarding the breathing difficulties and GERD symptoms you're experiencing after your tummy tuck.

It’s understandable to be concerned about these symptoms, especially when they seem to be related to your recent surgery. The tightness in your abdomen, combined with the sensation of not being able to fully inflate your lungs, can be distressing. While it’s not common, some patients do report feeling short of breath or experiencing digestive issues like GERD after a tummy tuck.

The tightness you’re feeling in your abdomen is likely due to the muscle repair and the removal of excess skin, which are key components of a tummy tuck. When the abdominal muscles are tightened, it can create a sensation of constriction, and in some cases, this can lead to difficulty taking deep breaths. Additionally, the pressure from the tightened abdomen could potentially affect the diaphragm, which is the muscle that helps your lungs expand and contract during breathing. If the diaphragm is restricted or displaced upward due to the tightness of the abdominal wall, it might contribute to the shortness of breath you’re experiencing. GERD, or gastroesophageal reflux disease, can sometimes develop or worsen after abdominal surgery, particularly if the surgery has caused changes in the pressure dynamics within the abdomen. The tightness in your stomach could be contributing to increased pressure on the stomach and esophagus, leading to reflux, especially after eating.

Given these symptoms, it’s important to have a thorough evaluation to rule out any serious underlying issues. While your surgeon may feel that the surgery did not cause these problems, it’s essential to listen to your body and seek a second opinion if necessary. Consulting with a gastroenterologist or a pulmonologist might provide additional insights into what’s causing your symptoms and how best to manage them. In the meantime, eating smaller, more frequent meals might help reduce the pressure on your stomach and esophagus, potentially easing both GERD symptoms and the sensation of fullness that makes it difficult to breathe. Additionally, sleeping with your head elevated can help reduce GERD symptoms by preventing stomach acid from flowing back into the esophagus. Gentle breathing exercises may also help you regain some control over your breath and reduce the feeling of tightness in your chest. If your symptoms persist or worsen, it’s crucial to consult your surgeon again or seek a second opinion to ensure there are no complications from the surgery that need to be addressed.

Your health and peace of mind are important, and getting the appropriate care to manage these symptoms will help you feel better and ensure the best possible outcome from your surgery.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

This is possible and the most likely cause of your symptoms. This is not a cause for concern over the longterm.
However, there are potential causes of shorteness of breath which are an emergency. The most severe concern is a pulmonary embolism. You should relate these symptoms to your physician as soon as possible.

With significant tightening of the rectus muscles of the abdominal wall, there is a decrease in intra-abdominal space. Ones internal organs will be squeezed and this could increase pressure on the diaphragm. I have heard this complaint in the past but rest assured it is a temporary condition. The pressure should gradually diminish and your symptoms should subside.