8 months post op - what could be causing my swelling? (photos)

**Post-Tummy Tuck Abdominal Swelling: Potential Causes and Solutions**

Dear Gentle920337,

Thank you for your question regarding the potential causes of your abdominal swelling eight months post-operation. I appreciate the details you've provided, along with your pictures.

Primarily, there are four factors that can lead to abdominal distension: excess skin, excess fat, a weakened rectus abdominis muscle, or the contents within the peritoneal cavity pushing the rectus abdominis muscle outward.

Upon examining your pictures, a few observations can be made:
- You don't seem to have excess skin.
- There isn't an apparent accumulation of abdominal fat.
- Your rectus abdominis muscles were surgically sutured, suggesting they aren't the weak link here.

Given these factors, the primary element likely causing the distension of your abdomen is the contents of your peritoneal cavity. This cavity holds several organs, including the liver, gallbladder, small intestine, and parts of the large intestine.

From your shared history, it's evident that your abdomen becomes distended after meals. This suggests that the food entering the peritoneal cavity may be causing this swelling. The abdominoplasty likely isn't the issue; rather, it seems to be related to your dietary intake and how your body reacts post-consumption.

For this reason, consulting a registered dietitian or a gastroenterologist would be beneficial. They can provide guidance on dietary choices that might reduce bloating, abdominal discomfort, and distention after meals.

I hope this clarifies the potential causes of the swelling you're experiencing eight months after your tummy tuck. Wishing you the best on your recovery journey.

Sincerely,
Dr. Katzen.

If you scan showed no fluid, then you may be having internal issues, especially with your colon. I would suggest meeting with your primary care physician and being checked for food allergies.

At eight months post op the majority of your swelling will have resolved and you are close to your final results. If the scan revealed that the muscle repair is intact then the fullness could be from visceral fat. This is the fat that surrounds the organs and is behind the muscle wall. This fat is not impacted by liposuction or a tummy tuck, but instead through weight loss. Fullness can also be caused by GI issues or a seroma. I encourage you to meet with your surgeon for further evaluation.

The most common reason to have bulging of your abdomen after a full tummy tuck is excess visceral fat. This can only be reduced with weight loss. It’s not that difficult to differentiate visceral fat versus insufficient muscle tightening. Muscle tightening failure is exceptionally rare and having access visceral fat is almost always the reason patient complaining of bulging after this procedure.
Follow up with your provider or get in person second opinion consultations
Best,
Mats Hagstrom, MD