Bulging and Hard Upper Abdomen After Tummy Tuck

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.

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

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.  

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

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.

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:

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!

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.

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.