How Do I Know if the Swelling Has Subsided from Tummy Tuck?

Question

It had been 12 days since my Tummy Tuck and I can't fit into my jeans yet. Is this normal? I thought I would be smaller.  I don't have the roll of fat I use to have, so how can I tell if its swollen or if this is it? I've been wearing my husband's sweatpants, and I'm hoping I can start wearing my normal clothes. Thanks for any information you can give me.

Steven H. Williams, MD · Answer

Thanks for your question -
It is common to have abdominal swelling after abdominoplasty. 
Abdominal contour is dependent on:
Skin envelope
Abdominal fat (subcutaneous and intrabdominal)
Muscles tightness
Intrinsic Swelling
Fluid collections
Skin Envelope -
People complaining of "abdominal bulge" after tummy tuck typically do not have issues with too much skin - that points to issues underneath the skin.
Abdominal fat -
This can be an issue in people who may be a little bit over their ideal body weight at the time of abdominoplasty. Ways to fix this include the tried and true diet and exercise or liposuction. Be sure to allow enough time between tummy tuck and liposuction to minimize complications.
Muscle tightness -
Muscles plication (or tightening) is usually a part of abdominoplasty. Either failure of the sutures or some laxity can cause a bulge. If the change in your contour was sudden or if you felt a pop - think about the plication having ruptured.
Swelling -
This can be the most common cause of contour issues post-abdominoplasty. Patients typically have swelling for two reasons. First surgery causes trauma and the body's response to trauma is to bring additional fluid into the area that has been traumatized. In addition, abdominoplasty involves dividing lymphatic channels (very very small conduits that normally pull fluid out of tissue) - until these channels grow back the area will not be able to remove excess fluid.
It is usually the most dependent (lowest) part of the surgery that stays swollen the longest.
The majority of swelling usually resolves after the first 4-6 weeks but there may be residual swelling for up to 6 months.
Fluid collections -
Seromas (serous fluid collections) or hematomas (collections of old blood) can cause distortions of contour. Normally this will improve on its own but may require drainage.
I hope this helps.

J. Timothy Katzen, MD, FACS · Answer

Hello nicole123,

Thank you for reaching out with your question about swelling following your tummy tuck procedure. Swelling is a common occurrence after any surgical procedure, including tummy tucks, and it can take some time for it to fully subside.

Typically, the majority of swelling will start to decrease within the first few weeks after surgery. However, it's not uncommon for residual swelling to persist for several weeks to months, especially in the lower abdominal area. It's essential to remember that every individual's body responds differently to surgery, so the timeline for swelling resolution can vary.

To gauge whether your swelling has subsided, you can look for several signs:

Improved Comfort: As swelling decreases, you may notice that your abdominal area feels less tight and uncomfortable.
Reduced Size: While you may not fit into your pre-surgery jeans immediately, you should gradually notice a decrease in the size of your abdomen as swelling diminishes.
Flattened Appearance: As swelling resolves, your abdomen should appear flatter and more contoured, with less puffiness or fullness.
Improved Clothing Fit: As your abdomen reduces in size, you should find it easier to wear your regular clothing, including jeans and other fitted garments.
It's important to practice patience and continue following your surgeon's post-operative instructions, including wearing compression garments as recommended. Additionally, maintaining a healthy lifestyle with proper hydration, nutrition, and activity levels can support the body's natural healing process and reduce swelling more efficiently.

If you have any concerns about the progression of your recovery or the persistence of swelling, don't hesitate to reach out to your plastic surgeon for guidance and reassurance.

I hope this information helps, and I wish you a smooth and successful recovery from your tummy tuck procedure.

Sincerely,

Jerome Edelstein, MD · Answer

It is still early on in your recovery so any swelling is still probably very prominent. Swelling can last for months to a year, but you should be able to fit into your jeans again after this swelling subsides.

Farbod Esmailian, MD · Answer

12 days is very early on and it takes about 4 months before a lot of the swelling has subsided.  So it is hard to say if you have fluid collection (seroma) or something else is going.
I would advise you to see your plastic surgeon and have him or her address your concerns.

Bryan Curtis, MD · Answer

Observing the reduction in bruising, redness, and feeling less tightness in the treated area are indicators that the swelling from a tummy tuck may be subsiding. However, it’s crucial to follow your surgeon’s post-op instructions and attend follow-up appointments for an assessment.

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