9 months after tummy tuck - Swelling and tightness still present. What can be causing this? (photos)

Hello @tplan, thank you for your question and showing you pictures. It is important to take into account several aspects among which is the surgical technique applied, and to evaluate if there is something else at a systemic level. Remember that a surgery has a process for healing that can take to a year. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Dear tplan,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

At 9 months post-op, persistent swelling and tightness could be due to:
Scar tissue (adhesions): Internal scars can cause tightness and discomfort.Residual swelling: Some people take longer to fully heal.Muscle repair: If muscle tightening was done, it may still feel tight or painful during exercise.Nerve healing: Nerve regeneration can cause discomfort.Your flat belly button might be due to surgical technique. If the discomfort persists, consider a second opinion. Healing can take up to a year, but your symptoms deserve attention.

For residual swelling and tightness, I would suggest being checked for food allergies. Your medical doctor can order these tests, and food allergies are very common. At this point in time, swelling is gone from the tummy tuck.

Swelling can persist up to a year or more after surgery. A tummy tuck usually includes muscle tightening and some of the tightness you are feeling could be continued healing from the muscle tightening. I would advise continued follow up with your surgeon and if you are really concerned, you can seek another opinion by a qualified plastic surgeon in your area.
Best of luck!

If your surgeon allows it at this point in your recovery try and increase excercise, walking etc
It appears that you may have gained some visceral fat during your healing time. Visceral fat is the fat under your muscles that is part of your gut.
Avoid alcohol and surgery foods like fruit juices and increase your calorie expenditures.
If you’re able to lose visceral fat - you tummy will be flatter.

I'm sorry to hear that you are unhappy with your results. Has your surgeon performed an ultrasound to check for a seroma? Was muscle repair completed? If not, you may be seeing abdominal wall laxity. It could also be visceral (internal) fat.

Based on the series of posted photos and your issues I recommend immediate lower abdomen ultrasound to see if retained seroma or just excess fat. If either only re operations can improve the results. Best to virtual consult with....

Tummy tuck recovery can be challenging for many people for a long period of time.
It’s not unusual for people to have concerns and issues with discomfort especially with certain movements for 6 to 12 or even 18 months. for some people it takes a few years to finally get used to the results and get comfortable with your new body.
Muscle tightening reduces the potential intra-abdominal space. Individuals who have even slight excess visceral fat may find an significantly increased in trouble domino pressure with a sensation of tightness most of the time.Assessing excess visceral fat is fairly easy to do an examination. if it takes a substantial amount of pressure to press in your lower abdomen then visceral fat maybe Contributing to the sensation of tightness and dislike bulging Sean on your lower abdomen on your after pictures.
Consider making notes about what your body feels like including with exercise and range of motion and set baseline pictures. try losing 5 pounds then compare notes and pictures.
You may need to lose 10 pounds to really get a significant change in the sense of tightness and the slight bulging that your abdomen still has.
If Rancho motion is still a challenge and doing stretching exercises is difficult then consider asking for a referral to physical therapy. A therapist can set benchmark goals and measure progress better than people can on their own.
Based on your preop pictures you were definitely a candidate for a full tummy tuck and a mini would not have given a good results. it’s hard to make a good accurate assessment based on the information posted but I believe weight loss and physical therapy will help in combination with giving it more time.
Your pictures show evidence of quality done surgery that was appropriately recommended.
Your scar should also continue to fade nicely for at least another nine more months.
I think you’ll find even a few pounds of weight loss with a good stretching routine and being patient timewise will make things better.
Best,
Mats Hagstrom MD