Bulging and Hard Upper Abdomen After Tummy Tuck

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.

Doctor Answers 7

Hard to know what bulging upper abdomen is

There are many reasons why you could be noticing changes in your shape at this time. Although there may not be a drainable collection of fluid, fluid may still fill the tissues, much like when you bump or bruise yourself and the area swells. Because lymphatic channels can be disrupted from a tummy tuck, this can sometimes take several months to resolve. Message can help.

Perhaps there was some differential in the tightening of the muscle layer. This also can equilibrate with time. Maybe a stitch tore out. Whatever the answer, I would give it more time to see if it begins to improve on its own. If it does, I would let time fix the problem. If it isn't getting any better by 6 months after your operation, another operation might be needed to correct the problem.

Ann Arbor Plastic Surgeon
4.7 out of 5 stars 13 reviews

Exclude fluid collection and muscle weakness

An upper abdominal bulge could be either a fluid collection or some loose abdominal tissues (assuming this is a new bulge and it was not present before surgery). A simple ultrasound will detect any fluid collection. Clinical exam could detect weakness of the muscle. CT scan is the ultimate test to examine all these tissues if everything else fails.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Ultrasound or MRI needed.

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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Continue to be seen frequently by your plastic surgeon

There are several possibilities to explain what is going on. These range from simple to complex. I would advise you to continue to follow up with you plastic surgeon and follow the instructions given. There are imaging studies that might be helpful which include ultrasound and MRI. I hope this helps!

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Bulging and hard upper abdomen after tummy tuck

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

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Tummy tuck post-op

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Bulging and firm area in the upper abdomen after a tummy tuck

Tummy tucks are a very popular and effective way to contour the abdomen. In our practice, we include liposuction with every tummy tuck. We strongly feel that liposuction is important technique that allows us to contour your body and reach areas of the abdomen that we otherwise would not be able to get to with a tummy tuck alone. Patients who undergo this procedure must understand that there is a significant recovery process. Patients will experience swelling and bruising that can persist for up to 6 to 8 months. In our practice, we provide our patients with the two separate compression garments that specifically apply pressure evenly to the areas that have been treated and also provide support for the patient's comfort.

It is possible that the area you are feeling can be a small area of swelling, a small amount of bulging in the muscles, or your body's reaction to sutures or other materials that were used during surgery. Your best bet at this point is to be evaluated by a board-certified plastic surgeon who can examine you and determine what the cause of this mass may be. They will then be able to recommend a surgical procedure that can help eliminate this lump.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 108 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.