I am 8 weeks post-op tummy tuck with MR. From day 1 after surgery I have seen an upper abdominal bulge. It is hard and not soft or spongy. It looks like that right after I get up in the morning and remains that way or gets a little worse as the day progresses. I have asked my PS about this and he said that he has tightened my muscles as much as possible and that it is my organs protruding out. Can someone please give me some advice as to why this happens and what can be done to rectify it?
Upper Abdominal Bulge 8 Weeks After Tummy Tuck with MR? (photo)
Doctor Answers 8
Upper Abdominal Bulge 8 Weeks after Tummy Tuck
In general, this can be the result of failed plication, fluid collection, intrabdominal fat and extrabdominal fat. In a lot of women the upper abdomen can appear to have more fat on it due to the fact the the rest of the flap is stretched thinner below. Liposuction after 3 or 6 months would be appropriate in this case after swelling has resolved.
Concerns after Tummy Tuck?
Thank you for the question and pictures.
Based on your pictures, it seems like you have achieved a very nice result after tummy tuck surgery. Frankly, your plastic surgeon's response seems reasonable, again based on your before and after pictures.
Some causes of abdominal wall "swelling" after tummy tuck may be:
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.
Tummy Tuck Bulge
Based on your before and after pictures, you have had a very nice TT result.
- I believe you have a tendency toward an "apple shape" which means you have internal (behind the muscle, inside the abdominal cavity) fat storage areas that can't be removed with liposuction or surgery. No matter how much the muscle (diastasis recti) is tightened, some upper tummy fullness will remain.
- Your loose skin and external fatty tissue (above the muscle, under the skin) has been removed with the TT.
- You may see more softening and less swelling in the tummy area for another 4-6 months. It will be easier then to determine what, if anything, can or should be done if the fullness is still present.
Thanks for your question and good luck!
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From your picture it’s very hard to see the bump you are talking about. Without an exam it’s hard to see what can be going on. It could be a hematoma that happens something after a tummy tuck. You need to get a second opinion if you’re not happy with your PS respond.
Upper Abdominal Bulge 8 Weeks After Tummy Tuck
Thank you for your question and for the photos you have attached. Based upon these it appears that you have a nice result. There are some limitations to tightening the abdomen--the contents have volume and cannot be compressed without severe consequence.
There may certainly be some swelling still present at 2 months. The possibility of a fluid collection can be determined by physical exam. EIther of these can contribute to the contour.
Your surgeon's explanation sounds right.
Flattening the Tummy
The upper abdominal fullness certainly can be caused by internal organs, fat or fluid collections beneath the skin. The fluid collections are diagnosed with a good physical exam. In some cases the abdomen can not surgically made pancake flat. These expectations need to be discussed at the consultation.
Tummy tuck Post-op
Dear Joym, judging from your pre-op picture, you seem to have got a nice result following the tummy tuck procedure. It would be difficult to determine the exact reason of the upper abdominal bulge without a clinical examination. However, in my opinion it could be due to residual fat in the upper abdominal region, or as pointed out by your PS, intra abdominal fat which can not & could not be addressed by liposuction.
It would be ideal to wait for a while for the tissues to settle down and then take a call with your PS after 8-10 weeks. The superficial residual fat can be addressed with a lipo procedure under sedation with local anaesthesia.
All the best!
Bulge after surgery.
The muscles can only be tightened so much during surgery. At some point, because every person has fixed mass volume inside the abdomen the surgery will not reduce the girth of the abdomen any more. Perhaps some weight loss will help to reduce your volume inside the abdominal cavity - hope this helps! Dr. Aldo.