Bulging and Hard Upper Abdomen After Tummy Tuck

Question

I had my Tummy Tuck on 12/20/08. Recently, my upper abdomen gets very swollen and my muscles feel very tight and like cards. What could be happening?  I have consulted with my surgeon, and he initially thought it was fluid retention.
He checked by placing a needle in the area, but there was none.  He said it's very impossible that the stitches used to pull my muscles together came loose. He told me to take it easy, keep wearing my girdle, and massage the area.  I was fine for a few weeks, then all of a sudden, here comes the swollen ab again.
Why is this happening? Is it normal, and will it eventually stop?  Can I take an X-Ray to find out what is happening? Am I doing something that could be causing this?  Please advise, much appreciated.

Richard J. Bruneteau, MD · Answer

The presence of a significant abdominal bulge several months
following abdominoplasty surgery, should be aggressively investigated.Especially if the bulge wasn’t present in the
immediate post-operative period.This
type of bulge could occur for a variety of reasons including swelling, seroma
formation, encapsulated hematoma, residual muscle weakness, recurrent
separation of the muscles, intra-abdominal fat, excess subcutaneous fat and
possibly fat necrosis.Under
these circumstances, it’s appropriate to obtain ultrasound and possibly MRI
studies.Depending upon the results,
revisional surgery may be indicated.For
these reasons, it’s important to consult your plastic surgeon.Your surgeon should be able to formulate an
appropriate treatment plan.

J. Timothy Katzen, MD, FACS · Answer

Hello amalex,

It's understandable that you're concerned about the changes in your upper abdomen following your tummy tuck surgery. There could be various reasons for the swelling and tightness you're experiencing at this stage of your recovery.

One possibility is that fluid may be accumulating in the tissues, even if there isn't a drainable collection present. This swelling can occur as part of the body's natural healing response, similar to how tissue swells when injured. Since tummy tuck surgery can disrupt lymphatic channels, it may take some time for this swelling to resolve. Gentle massage techniques can sometimes help encourage fluid drainage and alleviate swelling.

Another potential factor could be differences in the tightening of the muscle layer during the surgery. Over time, these differences may balance out as your body continues to heal.

It's also possible that a stitch used to secure the muscles together may have torn, contributing to the sensation of tightness. While your surgeon initially ruled out this possibility, it's worth considering as a potential cause.

Given the complexity of the healing process, it's often difficult to pinpoint the exact cause of persistent swelling and tightness. In many cases, these issues may improve on their own with time and conservative measures, such as wearing a binder and massaging the area as advised by your plastic surgeon.

An X-ray may not provide useful information in this context. It's best to follow up with your surgeon for further evaluation and guidance based on your specific symptoms and circumstances.

I hope this information helps provide some insight into your situation. Please continue to follow up with your surgeon for ongoing monitoring and support throughout your recovery journey.

Best wishes for a smooth and successful recovery.

Sincerely,
Dr. Katzen

Bhupesh Vasisht, MD · Answer

Just to be sure of your post. Your tummy tuck was done 10 years ago and now you are noticing a bulge? There are many possibilities as to the cause but if this is new then I would highly recommend an imaging study.  A ct scan can be a good place to start to look for the cause.  Hope this helps.  Good luck.

Otto Joseph Placik, MD · Answer

On rare occasions, I have seen the compression garments "gather" around your midsection causing a tourniquet like effect with swelling above this area similar to the swelling seen above a tight leg stocking

	On other occasions, this swelling is actually localized fat and may best be treated with additional liposuction which is not advised at the initial surgical procedure due to concerns with vascualarity and healing

	At this point, it may be worth a second opinion and possibly obtaining an imaging study to evaluate the cause for your bulging

Steven Wallach, MD · Answer

I am not sure of the timing when this question was posted.  Is this two years later?  If so, it may be scar tissue or weakness in the upper abdomen. Sometimes a CT scan can be very revealing.

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Bulging and Hard Upper Abdomen After Tummy Tuck

Answers (9)

Answer: Bulging and hard upper abdomen after tummy tuck

Answer: Bulging and hard upper abdomen after tummy tuck

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Answer: Tummy tuck post-op

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Our mission is to create a world where every investment in modern beauty is Worth It.