Hard Bulge After Tummy Tuck with Muscle Repair

Question

I am 8 months post tummy tuck with muscle repair. I have a hard bulge around my belly button area, and pulling 'stuck' sensations with certain movements. I feel very tight much of the time, and sometimes achey in my ab muscles. Does this sound like scar tissue that needs to be loosened to alleviate the discomfort? My recovery was without complication.

Otto Joseph Placik, MD · Answer

This is likely a combination of scar tissue and compromised fat around the belly button which is poorly vascularized.
Generally over time, this will resolve.
The tight feeling also tends to resolve unless you have gained weight since undergoing the surgery.
As mentioned, discuss your concerns with your surgeon to ensure that all is healing well and there is no other cause for your findings.

J. Timothy Katzen, MD, FACS · Answer

Hello Maximus, thank you for your question regarding the hard bulge and discomfort you're experiencing after your tummy tuck with muscle repair.

At eight months post-op, it is not uncommon to encounter some lingering tightness and discomfort, particularly if your recovery was otherwise complication-free. The hard bulge around your belly button and the sensations of pulling and tightness you describe could indeed be related to scar tissue formation. When the abdominal muscles are repaired and tightened during a tummy tuck, it creates a significant amount of internal scarring as the tissues heal. This scar tissue can sometimes form adhesions, which are bands of scar tissue that can cause the muscles and skin to feel tight or "stuck."

The hard bulge you are experiencing could also be due to residual swelling or fat necrosis, which is the death of fat cells that can occur after surgery. Another possibility is a small hernia, especially if you feel a lump that seems to protrude with certain movements or straining.

To address the discomfort and tightness, you might consider the following: Gentle massage can help break down scar tissue and improve flexibility. Some patients find relief through techniques like deep tissue massage or myofascial release. Physical therapy can also be beneficial, as a physical therapist experienced in post-surgical recovery can guide you through exercises and stretches designed to increase mobility and reduce tightness. Additionally, over-the-counter anti-inflammatory medications, such as ibuprofen, can help reduce discomfort and inflammation.

It's important to discuss these symptoms with your plastic surgeon. They can perform a physical examination and possibly imaging tests, such as an ultrasound or CT scan, to rule out other causes like hernias or unresolved issues from your initial surgery. In most cases, the tightness and discomfort will gradually improve as your body continues to heal. However, if the hard bulge persists or if you experience increasing pain, it is essential to seek medical advice to ensure there are no underlying complications.

Good luck, and I hope this helps address your concerns regarding the hard bulge and discomfort after your tummy tuck with muscle repair.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Armando Soto, MD, FACS · Answer

Hi there-
It is, of course impossible for me to know for sure without examining you and having a better understanding of how your surgery was done (there are many ways to tuck a tummy), but is sounds like you are experiencing some contraction of the scar tissue that formed under your skin.
Just as scar forms in the skin, it also does so underneath at the site of your muscular repair. All scar tissue is very inflexible, and also tends to shrink (or contract) over the first year or so. With certain movements, this will cause most patients to feel exactly what you are experiencing.
It is important to visit your surgeon to be sure you don't have a more significant problem (doubtful from the sound of things). It is also important for you to understand that at this point your wounds are about as strong as they're going to get- in other words, it's unlikely that these feelings mean you're causing yourself harm. Once my patients reach complete healing, I actually encourage them to do stretching exercises and yoga, to stretch the scar slowly over time and prevent these uncomfortable feelings.
Visit your surgeon- as long as things are good on exam, try stretching gently once a day.

Steven Wallach, MD · Answer

Tighteness around the umbilical region after a tummy tuck is not uncommon. The firmness usually softens over time. This may take up to a year.

Pat Pazmino, MD, FACS · Answer

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.

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Hard Bulge After Tummy Tuck with Muscle Repair

Answers (5)