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Post Operative Swelling Stages
In my previous blog post about post operative tummy tuck swelling I talked about how the blood supply is disrupted to different degrees using the two different types of tummy tuck techniques (standard vs. Lockwood). In summary, the more skin that is elevated and separated from the muscle layer, the more blood supply disruption you have. On this post we will address swelling of the tissues after tummy tuck and why compression garments following surgery are important to reduce swelling.
The body is made mostly of water, and there is a constant fluid leakage from the tissues balanced by reuptake of fluid into the lymphatic drainage system. When the lymphatic system is impaired, we get fluid accumulations. The fluid can accumulate between the tissues as interstitial fluid (like a soaked sponge), or outside of the tissues as a seroma (like a sac of fluid). It can also accumulate at some distance from the operative site, usually the upper thighs or legs.
The drawing above illustrates the various types of fluid accumulation following surgery. As you move from left to right on the illustration you have increasing swelling to result in these conditions:
normal skin ——> normal swelling ———- > seroma———>
Fluid accumulation can happen early on in the postoperative period. When the body is in the acute healing phase it produces a lot of fluid. There are also a lot of tissues cut by the surgery, so there is leakage from those areas. The lymphatic channels themselves, which are used for drainage of the fluid, are cut and interrupted, so drainage of the fluids is impaired. This is to be expected. Since we know that there will be fluid accumulation after surgery, plastic surgeons prepare for this by utilizing drains during the post operative period.
Swelling can also happen after the acute healing phase is over, during the prolonged healing phase. The long incision line across the lower abdomen interrupts a lot of lymphatic channels. Since drainage of the lymphatics goes from the extremities to the heart, the incision path blocks drainage until lymphatic channels get reestablished. This can take weeks or months. The swelling is manifested as swelling in the upper thighs, and in some cases in the lower legs. The abdominal skin flap can stay swollen due to lymphatic blockage weeks after surgery. This type of swelling requires compression, because swollen tissues themselves can cause more scarring.
Control of swelling starts with surgical planning. As was described in my earlier post describing the Lockwood technique of tummy tuck, the less you separate the tissues the better. This is because there is less empty space for fluid to accumulate, less tissue from which fluid leaks, more intact lymphatics to drain fluid, and tissues can heal faster. I prefer the Lockwood technique because separates less tissues than the standard technique After surgery, compression is very important. It prevents fluid leakage from the tissues, and once it occurs, the pressure forces it back into whatever drainage channels are available (drains or lymphatics). Tissues heal better and faster when there is minimal swelling.
The type of compression is important. Too much compression at a given point can stop blood flow and cause tissue death. Too little, and fluid accumulates. In my opinion abdominal binders (wrap around type) are inadequate because they shift and the shearing from it can disrupt the healing of the abdominal flap to the muscle underneath. Secondly, they can obstruct flow from the extremities back to the heart. This is why some people with abdominal binders can have swelling in the upper thighs.
To control swelling, I only use medical grade compression garments that go from the rib cage to just above the knees, with shoulder straps to prevent creases. The compression is uniform so there is not too much pressure in any one site. The compression in the thighs prevents any fluid buildup in the upper thighs and legs. In addition, in areas where I have separated a lot of tissue I put some foam pads to apply gentle extra pressure and prevent seromas. The compression garments are left continuously for two weeks (except for taking showers or baths), and during the day for another two weeks. This is a month of wearing garments. It is important to wear the garment for this entire period so that you are compressed during both periods of fluid accumulation, the acute (immediately following surgery) and prolonged healing phases (2-4 weeks out).
In summary, my experience has been that post operative swelling can be easily controlled with:
1) the appropriate surgical design (Lockwood technique)
2) prompt and prolonged compression with medical grade compression garments
Ricardo L Rodriguez, MD
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73 Comments
January 8, 2012 at 4:53 pm
Ala1216:
First of all, my advise is secondary to that of your surgeon because he did the surgery and he knows what his technique does in the recovery process.
My preference is for compression garments rather than abdominal binders. Rather than ice or heat, my guess is that you would benefit from something like one of the Veronique line of garments, you can look it up in the internet.
January 8, 2012 at 8:55 am
Hello. I am seven weeks post-op from a tummy tuck and umbilical hernia repair. My dr said I had very seperated ab muscles and he used multiple layers of stitching to close them back up. I had mesh placed to repair the hernia. My problem is that I was told I could go without the binder I have been using since my surgery. I have been “easing my way out of it” by wearing it “more loose” progressivly the last 5 days. My swelling had gone down considerably about 2 weeks ago but has returned, even before I started to reduce the tightness of the binder. My pubis area is VERY swollen and uncomfortable, as it has never compressed by the binder. I slept very little last night because of this, should I ice or warm the area for relief? Help please! Thank You
December 25, 2011 at 11:58 am
Lina:
First of all, you need to relax.
Generally I do not do anything about revisions until at least 4 months have gone by.
Your body is still evolving. The good thing is that it is highly unlikely that whatever is going on above your belly button now is dangerous.
As far as what you need to do, there’s nothing I can suggest since I don’t know what went on in surgery, and I would need to see and feel the area to get a sense of what’s going on.
If it gets bigger some days or at a certain part of the day it probably has to do with localized swelling.
Merry Christmas!
If you appreciate what you have learnt here please spread the word about my website to your friends and online.
December 20, 2011 at 8:45 pm
Hi Dr. Rodriguez. Okay, I am freaking out. I am currently nine weeks postop. At about two weeks part of my incision opened up and my PS waited an additional two weeks before closure to ensure healthy tissue so that I would have no problems with infection and he also put me on an antibiotic before as well. So now I am at nine weeks postop and five weeks from my incision closure. The incision looks great and I feel pretty darn good. My only concern at this point is the lump I have above my belly button. Some days it seems a little bigger but lately it has been consistent in its size and I am afraid it will be a permanent part of my anatomy now and I’m not happy. I wore my compression garment religiously for almost eight weeks and did not attempt exercise or anything strenuous until my PS released me to do so just a few days ago (at my nine week postop visit). Is this thing going to go away? Should I massage, go back to my garment? I have brought this to his attention many times but the answer is always the same “its just where I have more fat build up.” Ugh! He said that since some days it is worse than others I can expect to have my final result look like the day that it is not as prominent. However, for the last week it has been consistent in size and I’m afraid it will stay that way. Please give me some advice before I have a heart attack!!!! Thank you!!!! P.S. I just started exercising two days ago and was hoping that maybe this area just needs to be strengthened? I don’t know. HELP!!!! Thank you!!!!
December 19, 2011 at 9:29 pm
Boo:
What did your Doctor tell you?
November 29, 2011 at 3:04 pm
Hi!~ I am post op 2 weeks today. I had a breast augmentation and abdominalplasty at the same time. I went with silicone implants under the muscle. I went with 250cc. I am 5’8″ and 34 years old. I have two children and have lost 110 lbs over the last 5 years through eating healthy and exercising.
My doctor was suppose to complete a mastopexy as well. But decided to do it in 3 mths time.
My only down fall is that I am experiencing burning pain in my right arm pit and down my arm. I can not lift my arm nor lay in bed without the sharp pain. There is no incision in my pit area. Feels like what i guess nerve damage is. I started to take B12. I am wondering if there is anything more i can do. I am thinking that I may get relief when my lift is done in 3 mths? What do you think? Also I have little swelling( waterbed feel) above my incision on my tummy….wondering if there is anything you can take that is natural..that will help reduce this quicker.? Thank you so much for your time.I have discussed this with my doctor. I just wondered second opinion.
November 28, 2011 at 9:19 pm
Dr.
I have been reading your blog on swelling and have some concerns. I’m 13 day post opt tummy tuck and lipo in my dori rolls and flanks. My stomach is pretty flat by my navel, however my lower ab is so tight and swollen to me. I was concern that i may have a seroma because of the swelling to me. Im standing up straight and I get my drains remove tomorrow. Im only producing 7cc each drain for the last 3 days. So Im not releasing alot of fluid but im still swollen. Should I get a different compression garment or do you think its a seroma?
November 19, 2011 at 4:00 pm
Cheri:
Although 10 weeks is still a little early, by 16 weeks you should have an appointment with your surgeon and expect a plan of corrections. You don’t have to wait more than 4 months by then things look pretty much what they are going to look like.
You should expect to pay a small amount for the use of the operating room and anesthesiologist, as well as some for the doctor, but it should only be a fraction of the original cost. Remember, you paid for the Doctor’s professional service, not for a result. Nobody can guarantee a particular result.
If you have lost trust or confidence in this surgeon, then you may want to do a second consultation with another Surgeon.
If you wanted my opinion, Kelly can help you set up a virtual consultation (kelly@cosmeticsurg.net).
November 18, 2011 at 10:46 pm
Hi Dr. Rodriquez, I had tt with breast lift 10 weeks ago. The Dr did not use drains, my incision opened on right side which caused alot of drainage but the left side did not drain and it is still swollen more and my tummy is very uneven. I also had a previous gall bladder surgery and had the large scar across my abdomen which has caused my tummy to be uneven on that side. THe top part of my stomach seems bigger also. My upper thighs are also much larger than before and I have this horrible mons pubis. Basically, I have swelled so much and I am still pretty swollen. What can I do? How long with this last? By the end of the day of course, it’s even worse. I’m very unhappy and my Dr keeps telling me to give it time. I wanted lipo by Dr didn’t think I needed any but I definitely think I did. I don’t have that pretty hour glass figure like I wanted. My right breast is also much lower than the left. Can this be fixed in Dr’s office? Can he lift the right more to match the left? HELP!!!
November 16, 2011 at 10:17 am
Sarah:
One of the amazing things to me in this whole internet process is that I could actually help you with out having even spoken with you or met you. Don’t you love the web?!
November 15, 2011 at 9:41 pm
It makes sense to me. I am not a fan of girdles, but I will try. When I am in pain, compressing the area with my hands helps. Thank you again for your help and yes, I will spread the word!
Sarah
November 15, 2011 at 7:01 pm
Sarah:
You need more compression.
Get a compression garment, like the Spanx brand that is more compressive than regular pantihose or girdles.
Hope this helps.
Spread the word about my blog!
November 11, 2011 at 12:37 pm
Thanks a lot for your response. Yes, the area swells more at the end of the day, or if I have been standing for a long period of time. It feels hard and tense. I had an ultrasound done with “normal” results. I will schedule
an appointment with a plastic surgeon as you recommended. What should I expect if the problem is swelling in the scar region?
Thanks again for your time and for sharing your expertise.
November 11, 2011 at 11:28 am
Doina:
When there is a seroma it is not unusual to have to drain it 2 or 3 times, sometimes even more. Are you compressing it? that is always helpful, maintaining compression 24/7 after drainage.
Let me know how it turns out!
November 11, 2011 at 11:21 am
Sarah:
I don’t think it’s a seroma, but it could be swollen scar tissue. If it swells more at the end of the day it’s a sign that it is probably swelling in the scar region. If it wobbles like a water matress, its probably a seroma.
Go see a plastic surgeon. Have you had an ultrasound of the area?
Anyways, good luck and let us now what they find out!
November 9, 2011 at 10:02 pm
Hi ok I had a tummy tuck and a breast lift 3 weeks ago last week I went back to the dr because I was swelling on one side of my stomach so he drained it with a needle but today I still have some swelling on the same side is that normal?
November 8, 2011 at 8:39 pm
I had a partial tummy tuck 8 years ago. After my surgery I developed seromas that were treated by my doctor. Now I am having symptons such as swelling (looks like small pillows) and pain on the left side of the abdomen. I have had all kinds of tests done and nothing has been found.
Is there a possibilty of developing seromas after such a long time? Since I moved from where I had my surgery done, what kind of doctor should I consult? …a general surgeon or a plstic surgeon? Thanks a lot for your time and advice.
November 1, 2011 at 9:45 pm
Sarah, I sympathize with your plight, but right now, you need to have these questions answered by your surgeon. Call his office, his advice will be a thousand times more valuable than that of a Doctor who has never seen you and does not know the details of your case.
November 1, 2011 at 6:07 pm
I’m down 140 lbs, and on October.28th I had received a tummy tuck, and a breast augmentation. I have three drains in me as of now.. my legs-thighs and butt have tripled in size. What can I do to make the swelling go down? This abdominal wrap Is hurting my rib cage more than anything. Killer. Thanks for your time, much appreciated.
October 30, 2011 at 3:47 pm
Cecilia:
The vagina can get very swollen because it is not in the compressive part of the garment. You should not ice it because your sensation in that area may be impaired for the next few days and can actually damage the tissues because you will not be able to feel very well.
I usually recommend to my patients to use a snug pair of panties over the garment to keep swelling down in that area.
Most importantly, if you are that concerned, you should demand to be seen by the Dr.
Not having done your surgery, or even seen you, my opinion has very little value.
Good luck, and get seen by the Doc
October 27, 2011 at 1:03 am
I had saline breast implants (through my bellybutton). & I had liposuction done on my axilla (arm), tummy, hips, inner & outer thighs two days ago. The compression garments seem very, very tight. Is this normal? Also, my vagina has swollen severely & is VERY uncomfortable. I was told this was normal & that I could not put ice “down there”. Is this true? I would think it would help with the swelling & pain? Please help! Thank you!
October 1, 2011 at 3:16 pm
Erma:
You need to do 2 things:
1) Have a frank discussion with your surgeon and ask him what your options are, and what his plan is if this doesn’t resolve quickly.
2) If you are not happy with what he has to say, get a second consult.
September 23, 2011 at 6:57 pm
I have had a drain in for almost 2 months, I was not put into a compression suit, untill I went back to have fluid taken out with a needle then they put a girdle type around my waist. Help me out still draining. what if it doesn’t stop draining when they take this tube out of my side? Unhappy so far. thanks
August 23, 2011 at 8:40 am
Raisa:
Your mother most probably has a seroma. She should go to a local surgeon to evaluate it. She may need a drainage of the seroma.
I do not think the swelling comes from the hit, most likely it has been present, but the fluid accumulates progressively.
Let me know how it turns out
August 17, 2011 at 7:23 pm
Hi, My mother did a tummy tuck in colombia with a surgeon who has worked on myself a few times and many other people I know. Everyone looks great and we’ve had a lot of success with him. After 3 weeks more or less of perfect recovery she has developed what looks like liquid retention or swolleness. This all happened shortly after a family memeber was assisting her with putting on her garment and accidently hit her extremely hard. Could the swelling just be from the hit ? or should there be a concern?
August 11, 2011 at 9:02 pm
Colleen:
You probably do have a fluid collection (seroma), if what you describe is correct. You should consult with a plastic surgeon in your area. In the meantime, wearing your garment may help the fluid reabsorb.
Let me know how it turns out!
August 11, 2011 at 10:12 am
I am two months out of my tummy tuck & breast augmentation. I wore the compression garment you described and had excellent results. It also made my incisions and tummy feel more secure and less painful; but now that I have eased off wearing it due to the heat I am finding that when I poke at my stomach it does this wave..so that would be fluid build up?
I went to Colombia for my surgery, so running to my surgeon is outta the question. So, my question is how long after surgery does the swelling and fluid build up? I did loose 140lbs and my prob was a mass of connective tissue above my belly button so I am very happy. although, I feel like my skin is stretchy,Is this normal?
July 14, 2011 at 1:12 pm
Anamaria:
The back pain is probably related to other causes than the wound itself. The pain in the groin may be related to a nerve trapped in the scar.
For a real opinion, however, you should really consult with a physician who examines her directly.
Hope she feels better!
July 11, 2011 at 9:24 am
Hi Dr. Rodriguez:
My mother-in-law had a tummy tuck and some minor love handle liposuction in March. We flew out of the country and my uncle did the sx. She ended up developing an area of necrotic tissue between the bellybutton and the pubic area, which is almost completely healed by now. She seem to be improving until a couple of week ago when the surgeon who is doing the followup used silver nitrate to cauterized the last of the incision opening. She is in a lot of pain, but her main complain is pain in her lower back directly opposite the area of the healing opening and pain in her left groin (this one she has had since about a week after the sx). I guess she is wondering if the back pain could be related to the open wound she had for a while or just due to change in the level of activity. She is 62 and in pretty good shape and quite active.
July 4, 2011 at 3:14 pm
Ceri:
You need to ask your surgeon. I know nothing of the garment you are using or the technical details of the procedure, so any opinion of mine on the subject would be based on ignorance.
But glad for you that you are getting a new body!
July 2, 2011 at 7:39 pm
Hi 5 days post op from t tuck & lipo… I take my compression garment off at night is this ok ? Thanks :0)
June 26, 2011 at 8:47 pm
Martine:
This is normal within the post operative period, even up to a month postop.
Compression garments help, even after a month. At this point I would recommend some of the higher compression garments such as “Spanx”, which you can get at many retailers.
Good luck and congrats on your new figure!
May 30, 2011 at 9:27 pm
i am 10 weeks post op tt. within the past 2 weeks i started to swell in the area between my belly button and surgical incision. is this normal? also feeling very tight when i stan up straight.
May 19, 2011 at 4:16 pm
Jason:
Definitely a local plastic surgeon near you. Unfortunately, she will have to pay, and some surgeons may not be willing to care for another surgeon’s complications.
Call around, and if there is a university center near you with a Plastic Surgery Division that would be your best bet.
May 19, 2011 at 1:10 am
My wife is from Peru and when she decided to have a tummy tuck she insisted on doing it there. She had a tummy tuck, breast augmentation and lipo done on her sides and back just above the butt. She was in the hospital for 9 days and after day 7 the drains were removed. After returning for a followup visit the removed several cc’s of fluid from both her lower back and stomach. She went back 5 times for additional aspiration before returning to the states. Each time she returned the fluid removed was less but she does have some minor ripple effect in both areas. She wears a compression suit that covers like a one piece bathing suit that zips in the front. Obviously she cannot visit the doctor that performed the surgergy so what should we do about removing the excess fluid now that she is home. She looks great and we thoroughly investigated the surgeon, in fact he is one of the most respected plastic surgeons in the entire country but we are still concerned about this fluid. Should we try contacting a local plastic surgeon to have them look at her or maybe our family doctor. Please advise… Thanks
May 18, 2011 at 9:07 pm
Mis_flo:
The best person to ask all these questions is the surgeon who performed your surgery. He knows all the details and is in the best position to help you.
I suggest you call him and ask all these questions in person. If the answers are not satisfactory, then get a second opinion from somebody who can look at you and examine you.
Any suggestions I could give would be based on speculation and not really in your best interest.
May 18, 2011 at 3:27 pm
Dr. Rodriguez,
I am 5 weeks post op yesterday and I am having a lot of swelling in my inner thigh area. What can I do to prevent this? Should it be of concern to me or is it normal at this stage? This is my 2nd tummy tuck in 4 months the first was not dont very well and so the surgen redid the lipo and pull of the skin. I did have a few seromas with the first but no swelling in the legs. any info would be great
May 14, 2011 at 4:43 pm
Andrea:
I think for this you need to talk to your Plastic Surgeon. He knows how long his patients take to settle in and when it is safe to resume activity.
I am really happy for you and I’m sure that since you are watching your diet, once you start working out you are going to look absolutely smashing!
May 14, 2011 at 11:49 am
7 weeks post op…… Love my tummy tuck! However, I am experiencing swelling, and have some concerns. I was FLAT and beautiful at 4 weeks. After 4 weeks I went to wearing my compression garment (medical grade) on an “as needed” basis… Only when I knew I was going to be more active than normal. I have NOT returned to my regular workout routine, but would like to know when I can return to Pilates and power walking. I have been careful with my diet to eat properly. I want that FLAT look back. I don’t want to look like I’m 3 months pregnant. HELP!
May 10, 2011 at 10:35 am
Wendy:
I love Spanx, but they are not ideal for the first few days after surgery. Mainly, they don’t have a zipper, which helps in the postoperative period when things are tender. You don’t want to be squeezing in and out of a garment when everything is tender.
Secondly, compression in Spanx is not as firm as it is in the specialized garments.
I do recommend them a couple of weeks after surgery. My wife loves them!
May 10, 2011 at 10:23 am
Laila:
For postoperative advice, the best person is usually your own surgeon. If you are still concerned, call him again and tell him about your concerns.
It is impossible for me to offer an educated guess not knowing what the operation was, or seeing the problem now. The swelling may be scar tissue or fluid, but I really do not think it will be permanent. I do think you need to see your surgeon as he will give you a better strategy to deal with it than I can, since he is there, and he knows what the situation is.
Good luck and keep me posted!
May 8, 2011 at 5:31 pm
Would spanx be a comparable alternative to the garment you mentioned?
May 6, 2011 at 1:23 am
Hi, I had an accessory breast removed from just below my left armpit 2 weeks ago. There was a drain put in for six days and then removed. The area has remaind swollen since the surgery but in the last 4 days it has swollen really big. My surgeon says it is post surgical trauma and will subside in about six weeks but I’m still worried. The swelling looks bigger than the accessory breast that had been there! is it possible that some breast tissue still needs to be removed? Also I’ve not been too stringent about wearing the compression garment, I wear it about 6 to 7 hrs a day. Is that causing the swelling and if i dont wear the garment regularly will the swelling become permanent? Please do get back on this as I’m deeply worried.
May 3, 2011 at 8:18 am
Gus:
The amount of drainage has many contributing factors, including the use or non use of compression.
For example, even with compression, a patient who is very active may get a seroma, even with faithful use of compression. A persons weight is also a contributing factor. Surgeon’s technique also play a role.
So yes, in your case you got seromas either way, but that does not mean the use of compression garment is useless in preventing seromas.
When you take large groups of patients with similar conditions and compare compression to no compression, there is a significant difference in frquency of seroma complications in patients who do not get compression.
Sorry to hear about your problems! Hope every thing turned out well in the end.
April 17, 2011 at 8:27 pm
I’ve had two tummy tucks. A full and a mini. I used the compression garment after one of the procedures for 6 weeks. The second time around I got lazy and used it on and off. The amount of fluid retention and what the doctor drained weekly was almost the same.
March 6, 2011 at 1:45 am
Rae:
This is the type of judgement which can be best made by the surgeon examining you.
It seems both you and him are doing the appropriate things.
Sometimes these things just take time.
February 28, 2011 at 12:49 am
I had a conventional tummy tuck on Feb 15th. On Feb 21st I started with brownish/red drainage from my incision just above my pubic bone that constantly drained with my lower abd feeling firm. I went back for another appt on Feb 25th nothing with needle aspiration. The dr took cultures and started me on antibiotic all though he does not feel it is infection. The drainage finally stopped today, but my lower abd from the belly button down and from hip to hip is swollen. It is soft when I lay down but firm when I stand with pressure. I am wearing my compression garment 24/7 but a little concerned about this. I am not sure if this is a hematoma or a seroma. I do not have the ripple effect nor do I have an indentation with pressure to area.
October 10, 2010 at 8:42 pm
Makemeheal.com usually has them
September 12, 2010 at 3:32 pm
where would one order the compression garment that you recommend?
August 2, 2010 at 9:57 am
Shayan:
There are two possible reasons for your large tummy after hernia repair.
The first one is that you still have a lot of fat inside your abdominal cavity. You can find some info about different treatment alternatives available in this post.
The second one is that despite the fact you have a mesh, the mesh was sown in with a gap between the rectus muscles. Read this post about the rectus muscles.
It is impossible for me to determine what would help you unless I saw your pictures and had a chance to chat with you. If you are serious about going forward, contact Kelly at kelly@cosmeticsurg.net
July 23, 2010 at 2:26 pm
I had surgery of harnia five years ago. 16 by 16 inch mash was used. I still have a big tummy. I have very controlled diet, but i’m worried about my big tummy. I’m 35 years old lady with two kids.
July 3, 2010 at 12:43 pm
It will resolve,you just have to be patient. It is surgery, and people forget that the body has a lot of work to do.
Luckily, it seems your surgeon is in top of it and has given you the access to reach him as soon as you need it.
So relax, you are in good hands.
July 3, 2010 at 4:04 am
Hi Dr. Rodriquez. Thanks for answering my questions. Yesterday I went to my doctor and they decided to go ahead and remove my remaining drain but I do have a little swelling still in my lower abdomen. He said he doesn’t believe it looks like a seroma, but he mentioned how to “test” it myself and to call them immediately if my skin “bounces” back like a waterbed like you mentioned. I don’t think it’s doing that……..it just seems swollen but I don’t see a waterbed or ripple effect when I press on it. The swelling is along my incision line…….it’s like all my swelling traveled south and that’s why my upper torso is so flat and not swollen at all.
I am definitely going to order another compression garment. This binder has done nothing it seems. I was thinking of a binder that goes over my thighs and all the way up to the ribs…..because I had lipo in the hips and they are swollen as well.
Honestly, I researched tummy tucks a lot (from what I thought) and I had no idea that swelling would be such an issue. I sort of wish I had my tummy tuck using the method you use….the Lockwood technique. It seems like it’s so much less complicated. The swelling can be quite depressing and at first was making me wonder if having a tummy tuck was the right decision……but I try to remind myself that it won’t be swollen forever.
June 29, 2010 at 9:53 am
Michelle:
There are two possible explanations for this.
The first one is that sometimes fluid pockets are isolated from each other by areas where tissues have healed. So one drain ( the one that is still there is surrounded by healing tissue) can be draining very little, while there is a large pocket of fluid beside it.
The second one is that because of the seroma, the tissues themselves are swollen.
There is a simple way to tell. Put firm pressure with one finger for a couple of seconds in the most swollen part. Release suddenly. If the skin bounces back like a waterbed, you probably have more seroma fluid underneath. If there is an indentation where you put the finger in, the tissues themselves are swollen.
Let me know what happens.
June 29, 2010 at 9:42 am
Michelle:
Go ahead and order the compression garment.
I still think you are at risk of developing more fluid, so wear the garment 24/7. There is a risk that the seroma could get infected so I recommend you stay in close contact with your doctor.
At the first sign of redness, pain , or fever alert your doctor as you may need antibiotics. If the swelling persists you may need a needle aspiration. Regretfully, seromas are not that uncommon after a conventional tummy tuck with dissection all the way to the rib margin. That is why I prefer the Lockwood method of dissection.
June 29, 2010 at 9:34 am
Sofia:
I am sorry you are still having discomfort.
At two months after surgery, the best option you have is to get in contact with your surgeon. He knows exactly what he did and what technique he used, therefore he will have the best clue as to what is going on now.
It may be anything from normal postoperative swelling with his technique to a seroma.
You need to get very assertive with his office and demand to be seen ASAP. Tell the office staff that you are having problems. If they do not respond quickly, tell them that if you are not seen quickly, you will ned to go see somebody else and request a copy of your medical records. That should elicit a response.
You do need to be seen in person. An online consult at this point would only be speculative. You need a secure diagnosis.
June 26, 2010 at 11:56 am
I wanted to add, when I say that the fluids came out of my “incision” site, I don’t mean my tummy tuck insicion site. I meant the small area where the tube had been inserted. I was actually in my doctor’s office and we were trying to get the tape removed and the drain just fell out. She sort of massaged my lower abdomen and A LOT of fluid just came gushing out. Today I feel like I’m just as swollen as yesterday. The output on this second drain isn’t much and I don’t understand why……because I’m obviously still very swollen.
June 26, 2010 at 11:53 am
I had an extended tummy tuck 2 weeks ago and yesterday I went in to get my 2 drains removed, but I am having swelling in my lower abdomen….not in the upper part at all, just the lower section. One of the drains had come out before I even go to the doctor’s office. My body just sort of rejected it and has been pushing it out until eventually, it came completely out. So my doctor decided to leave this second drain in for a few more days. I’ve been wearing a binder that they provided me with and I agree that I just don’t feel like the binder is doing anything at all. It shifts around so much and it really doesn’t even feel tight even when I pull it as tight as possible.
When my tube fell out yesterday I pressed on my tummy and fluids came gushing out of my incision site literally and I watched the swelling go down. I feel like if I had been wearing a better medical compression garment then this swelling could have been prevented, but my doctor’s office said that the binder should be all I need. Do you think I should go ahead and order a compression garment online and what type do you suggest? I had an extended tummy tuck with lipo of my back and my hips. Thanks
June 25, 2010 at 10:04 pm
I AM MORE THEN 2 MONTHS AFTER TUMMY TUCK OPERATION, I STILL HAVE THE DRAINAGE, I AM BLOADING & HAVE A BIG DISCOMFORT INSIDE OF MY STOMACK.PLEASE RESPOND TO ME ASAP.CAN YOU GIVE ME SOME ADVICE OR INFORMATION. WHAT TO DO?THANKS A MILLION
May 20, 2010 at 6:40 pm
Beth:
Your problem sounds very involved. I would not even venture to guess what is happening in your situation.
My best suggestion is to go visit a Plastic surgeon so he can examine you.
We could do a virtual consultation here, but that would only be an overview of your options because to make any real decisions, a case like yours really has to be evaluated in person.
Call Kelly at kelly@cosmeticsurg.net for more info.
May 19, 2010 at 9:14 pm
Hi,
I had a kidney transplant in November which included a hernia repair using mesh. Immediately after the surgery I had vaginal swelling and fluid pockets in my abdomen. The fluid was removed from my abdomen on 3 different occasions at Interventional Radiology during Nov. and Dec., but the vaginal swelling never went away.
After the last fluid removal, I wore a wrap around binder on my abdomen. During Feb., March and April, I started accumulating fluid, but without fluid pockets, and the fluid didn’t show up on CT or ultrasound, but my abdomen and vagina were very loose, jiggly, etc. I was told the fluid was probably in the tissues. Surgeon through it could be the mesh causing the problem, so it was removed a couple weeks ago, major surgery cut on the same incision as the transplant, 5 days in the hospital. The mesh was tangled up inside when he went in. My incision is about 12″ – 13″ long. My surgeon also gave me a mini “tummy tuck”, which he typically does for me when he has to go in there (2 transplants, gall bladder removal & hernia repair, etc.). I hoped this was the culprit of all of my swelling, but my vagina is still very swollen and jiggly, and my upper inner thighs are very “heavy”. If I put my leg horizontal and twist it to the side, and let the inner thigh drop with gravity, it feels and looks like a water balloon. It’s very heavy. My vagina sticks to my leg when I sit.
I was just wondering if the binder I was wearing pushed the fluid down to my upper thighs. If so, is there anything I can do to get rid of this. I am so uncomfortable, and I think my transplant surgeon has done all that he can do. I was concerned that when the mesh came out, my legs and vagina wouldn’t resolve itself, although my abdomen is pretty much back to normal (I think due to the removal of all the loose skin from the ascites early on). How can I know if there is fluid in there, if it’s in the tissues, etc. I truly do not believe it is fat, because this all happened suddenly, and the rest of my body is of average size. And I don’t think I would gain fat in my vagina! So it is the vagina and upper inner thighs that I am worried about.
Any suggestions?
Thanks!
May 11, 2010 at 6:22 pm
Leigh:
You can tan under a bathing suit. I used to be a swimmer, so I know about tanning under a bathing suit. You should wear a sunscreen over the scar otherwise the scar will turn dark.
Otherwise, all these questions you should be really talking them over with your surgeon. He knows the details of his surgery best, and it would not be appropriate for me to comment.
Enjoy your summer with your new body!
May 11, 2010 at 11:06 am
how do you care for a tummy tuck incision, during the summer. does the sun penetrate bathing suits , will the suns rays cause the incision to become darker or turn white? what is best as far as ointments go to apply to the area as it heals. mine is 3 months old. my surgeon said just to use regular lotion, .also i am taking yoga now, is it OK to stretch abdomen muscles when they feel tight? will it loosen them ,
thank you..
May 4, 2010 at 7:51 am
Leigh:
After any body contouring procedure, there is fat redistribution throughout the body.
As for the efffects of diet, surgery, and excercise, read this blogpost.
Remember, weight is a function of calories in/calories out. You may need to start a calorie count of your food intake to see where you stand. Hope this helps!
April 30, 2010 at 11:35 am
I had a tummy tuck 1/26/10, I have noticed a 10 pound weight gain, I amhave exorcizing and eating right, and not lost 1 pound. My upper thigh size is larger, and my back seems to have gained fat .. I drink 64 oz. of h2o a day, walf 45-60 mins. 4-5 times a week, and just started Yoga. this weight is not moving! questions: after a tummy tuck, does fat collect else where like the back, thighs,arms.
could i still be retaining fluid 3 months later?
I used a waist binder, is the fluid that is in my thighs permanent?
April 11, 2010 at 9:56 am
Rosie:
The amount of postoperative swelling depends not only on surgeon technique, but on individual patient healing rates.
The only person fit to answer this question is your surgeon, because he knows what technique he used and has a good ballpark idea of how long his patients take to heal. Secondly, he can look at you directly and form a judgement as to how far along the process you are. Don’t be afraid to call your doctor for any questions or concerns. You paid him a lot of money not for a professional service, not just surgery, and you should expect him to answer your questions.
I always give my patients my cell phone number so they can reach me at all times, that keeps it simple and direct.
April 10, 2010 at 2:30 pm
i had a tummy tuck/lipo to back and flanks 3wks ago, i just wanted to know how long to expect swelling, i notice the swelling above incision i wear my binder qd just wanted a ball park figure thanks
March 17, 2010 at 9:10 pm
It is really hard to make judgements about a surgery performed by somebody else, without having examined you, etc.
I would suggest you call your doctor’s office tomorrow and tell them your concerns and let them know you are upset.
If you are dissatisfied with his answer, your next option is to get a second opinion in person. Whatever you do, do not take advice online, as the doctor cannot be aware of all the details necessary to give you the best advice.
Good luck and let us know what happens!
March 15, 2010 at 2:30 pm
I had a tummy tuck with body contouring. I am 25 days out and I continue to develop fluid. Once a week the PS will asperate the fluid with a needle. The problem is… I am accummulating fluid right after he asperates me and I have to wait an entire week until the next removal of fluid. I have been complaing about major back pain and upper thigh pain. My regular doctor and Physical Therapist said the pain is from fluid accumulation. The fluid is causing pressure to my spine. Can fluid cause this type of pain in my back and leg? Please help me. I would truly prefer the doctor put in a drain so that I don’t have such an accumulation by the time I go back to him on my weekly visit. Please let me know your suggestion.
August 14, 2009 at 5:25 pm
You really need to contact your surgeon to handle this.
You have had a complication, which is not unusual, but now you need to be under close supervision. This is not a problem to troubleshoot over the internet. You really need to see your doctor and ask him questions until you are satisfied you know what’s going on.
Above all, don’t take advice over the internet for a problem that needs to be handled in person.
Go see your doctor or his nurse in person today.
August 14, 2009 at 8:23 am
I’ve had tummy tuck /liposuction pre tuck (by another surgeon) and was placed on drains which was inserted for 3 days. I now have an ifection in the center of the wound which is not healed. I have accumilation of fluid which one day when I pressed my tummy came pouring out from the unhealed section. About 5 minutes later all that fluid has build up again. I am currently on co-amoxiclav 500/125mg and metrodadole 400mg. I would like to know if this fluid build -up after 3 weeks of the op. When I sit it the fluid seems to be pushed up forming a bulge until I stand for about 2 minutes where it will even up again. Do I have cause to worrry? I know the swelling will take some time to go down, but it’s this fluid that leaks out that is my concern. I would like to add that I do wear the medical grade compression garment with the straps. I only took it off once to wash it then back on it went. Any advice you can give me please?
June 1, 2009 at 9:47 am
It sounds like you may have a seroma, or fluid collection.
Call your doctor and tell him you think you have fluid. You need to do this as soon as possible.
May 31, 2009 at 11:44 pm
I just had a tummy ;tuck two weeks ago.. I have been wearing the compression wrap the doctor gave me but after reading what you suggest, I would like to get the medical grade compression garments. Can you tell me where I can get them and the cost. When I touch my stomack it feels like fluid running from side to side. Help thanks
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