Has my Tummy Tuck Muscle Repair Come Undone?

Thank you for the question. There are several causes of fullness of the upper abdominal area after abdominoplasty surgery. Some of these include fluid below the abdominal wall skin (seroma), swelling of the abdominal wall flap (tissue edema), continued excess  skin of the  abdominal wall, or laxity of the abdominal wall musculature (insufficient tightening of the plication  or relaxation/failure of the plication  sutures.

If you palpate the abdominal wall muscles in different positions (in the upright and bent over position)  you can get a good idea if the plication  repair is intact or tight enough. If you notice a significant “bulge” when you are bent or when your abdominal wall is relaxed (for example after expiration of a breath) then you may be experiencing failure of the plication repair.

Your plastic surgeon will be able to help you with this determination with physical examination done in the different positions.

Best wishes.

Without pictures or seeing you in person, it is impossible to give you specific advice.  However, if you have an unnatural bulge or contour issue, you should talk to your surgeon about your options.

 

Good Luck.

At four months, you do still have some swelling, which will likely diminish during the next few months.  In addition to the possibility of residual excess skin, swelling, or relaxation of the plication, it is possible for a patient who is in great shape before abdominoplasty to actually lose some definition and have added thickness of the epigastrium (area above belly button) after abdominoplasty because of the way skin and fat are rearranged during the procedure.  Plication of the abdominal wall concentrates overlying skin and fat in the midline.  If this extra thickness is not completely relieved by inferior displacement of skin and fat by flap transposition, added fullness above the belly button or below the breast bone (xiphoid process) may result.  My advice at this time:  Wait and see.