Swelling and pain 9 weeks post full TT, muscle repair, lipo to flanks & breast augmentation. Is this normal? (photos)

Question

I am 9 weeks post op, I have developed swelling, to stomach area and on one side where my flank lipo was? At 5-6 weeks post op my stomach was totally flat with clearly defined slim waistline, I started to do gentle excersise (squats and walking) not sure if this has caused the problem ?tummy feels very bloated, taught and swollen? I had a seroma drained at 3 weeks post op. I am concerned that I may need revision or that the surgeon hasnt stitched muscles enough?

Jed H. Horowitz, MD, FACS · Answer

Healing will continue for 2-3 months for the early period. This includes some swelling, bruising, malposition, color differences. Sensation in the breasts may also be abnormal and scars will be evolve. Tingling, burning or shooting pains in the breasts will disappear with time and should not alarm you. It is simply a result of the regeneration of your sensory nerves. If these sensations cause pain, repeated, local self-massage per your surgeon's permission may help. The purpose of the post-procedure #garment is to provide some gentle #support and to reduce swelling following a #TummyTuck or #Abdominoplasty. If it feels too tight or causes pain, take it off. Patients wear the #elastic garment for several weeks after surgery, as directed by their doctor. Some choose to wear it longer for several months for comfort.As I advise my patients, if your work keeps you sedentary, you may return whenever you feel up to it. If your work is strenuous, wait until your work activity does not cause any superficial pain. Some employers will modify a person’s job duties so they can back sooner, but without physical activity. Our office can provide our patients with a note stating they are not to engage in strenuous activity for a specified period of time. The note will not disclose what procedure they have underwent. Therefore, you may have to request a similar note from your surgeon if you are not independently employed. I recommend avoiding heavy lifting and strenuous #activity for six weeks following your surgery. With that said, it may help you plan your return to work accordingly.

As for heavy lifting and other #strenuous #activities, it should be avoided for until you have clearance from your surgeon. You may, however, do normal activities at any time if they cause no pain or #discomfort. Let your body tell you what you can or cannot do. Aerobic exercise will raise your blood pressure, which could cause late bleeding and harm your result. Once you begin exercising again, start gently and let your body tell you what it can tolerate. Don’t rush!!  If you have concerns about your #healing, or pain that you question to be unusual, it is important to call your plastic surgeon to discuss these further asked to be examined.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

Since there has been a change in your post op course, please contact your surgeon so he/she can examine you and recommend most appropriate treatment plan at this time.

The best way to assess and give
true advice would be an in-person exam.

Please see a board-certified
plastic surgeon that specializes in aesthetic and restorative plastic surgery.

best of luck!

Dr Schwartz

Tom J. Pousti, MD · Answer

Thank you for the question.
As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.
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)  for complete skin redraping  to occur.
I hope this helps.

Gregory A. Buford, MD, FACS · Answer

Without actually seeing you, it's really tough to know what is causing your swelling.  Since you mentioned that you did have a seroma drained early on, I would suspect that this could be causing you trouble again.  But there also could be several other issues which can mimic this, as well.As the previous Plastic Surgeon's suggested, I would also suggest that you go back and see your initial surgeon and have them identify what is going on.  Since he/she did the surgery, this would really be the best person to evaluate you.I hope this helps and wish you the very best!

Mark Deutsch, MD, FACS · Answer

Thank you for your question but it is difficult to assess your problem without a picture. I would advise you to contact your surgeon and go in for an exam. If there is suspicion for a fluid collection then an ultrasound may be needed. If the muscles were not tightened enough then you would not have looked "totally flat" at 5-6 wks. postop. You may have another seroma.

Swelling and pain 9 weeks post full TT, muscle repair, lipo to flanks & breast augmentation. Is this normal? (photos)

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Swelling and pain 9 weeks post full TT, muscle repair, lipo to flanks & breast augmentation. Is this normal? (photos)

Answers (9)

Answer: Swelling and pain 9 weeks after a tummy tuck

Answer: Swelling and pain 9 weeks after a tummy tuck

Answer: Swelling after mommy makeover

Answer: Swelling after mommy makeover

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Everything you need to know about Mommy Makeover

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