Thank you for your question and congratulations on being cancer-free. Based on your history of a tummy tuck with liposuction, followed by an open nephrectomy, the swelling and shape changes you’re experiencing could be related to several factors. First, it’s important to understand that abdominal surgeries, especially major procedures like a nephrectomy, can impact the healing and dynamics of the abdominal area. The swelling and hard feeling in your lower abdomen could be due to several possibilities: Lymphedema or Fluid Retention: The nephrectomy, combined with your prior surgeries, may have disrupted lymphatic drainage in the abdominal area, leading to fluid accumulation and swelling. Hernia Formation: The midline incision for your nephrectomy may have weakened your abdominal wall, creating the possibility of a hernia. This could explain the persistent swelling and hard feeling, especially when standing or walking. Scar Tissue (Adhesions): Internal scarring from multiple surgeries could be restricting normal tissue movement, leading to a misshapen appearance or hard areas in your abdomen. Residual Fat or Tissue Irregularities: The combination of liposuction and swelling from subsequent surgeries may have left areas of uneven fat distribution or scar tissue contributing to the misshapen appearance. To address these concerns, here’s what you can do: Consult a Specialist: Seek out a board-certified plastic surgeon who specializes in revision surgery and abdominal contouring. They can evaluate your current condition with imaging (such as ultrasound or CT scan) to rule out complications like hernias or significant scar tissue. Lymphatic Therapy: If lymphedema is contributing to the swelling, working with a specialist in lymphatic drainage massage or compression therapy may help reduce fluid retention. Surgical Revision: Depending on the findings, you may benefit from a surgical revision. This could involve tightening any loosened muscle repair, removing scar tissue, or contouring the upper abdomen and addressing lower abdominal swelling. Lifestyle Modifications: Supportive garments, avoiding activities that increase abdominal pressure, and maintaining a healthy diet can help manage swelling while you work toward a resolution. It’s unfortunate that your original surgeon has stopped communication with you. However, many experienced surgeons, including myself, are happy to provide consultations for cases like yours to help you regain confidence and comfort. I encourage you to seek a second opinion soon to ensure a thorough evaluation and appropriate care plan. Sincerely, Dr. Katzen