Swelling very bad when I don't wear compression garment, 7 weeks post op tummy tuck. Is this normal?

Hello, it is not uncommon to experience intermittent swelling after the binder is discontinued.  If the swelling is severe, perhaps it will be necessary to wear some type of compression (like spanx) as a transition from the binder to nothing at all.  I would recommend discussing this with your surgeon.

Everyone is different in how they heal, and as plastic surgeons we give instructions and advice on "averages".  I ask my average patient to wear a compression garment for up to 6 weeks after tummy tuck surgery.  However, you also had liposuction which will contribute to the swelling and could last for months after surgery.  If you swell, then listen to your body and continue the compression garment.  Spanx might be a more comfortable alternative but check with your plastic surgeon regarding his/her advice.  Best of luck with your recovery!

As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.Generally, abdominal wall "swelling" after tummy tuck may be related to:
1. Swelling in the soft tissues. This may take several months to resolve and may worsen with increased activity or at the end of the day. Patience is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle. this may consist of blood ( hematoma) or serum (seroma). This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound may be helpful). Treatment consists of aspiration; several episodes of aspiration may be necessary.
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication) of the rectus muscles. These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year (or greater) a complete skin redraping to occur.
I hope this helps.