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Ask a Plastic Surgeon / Abdominoplasty
Question 19
Question: 15 months ago I had a tummy tuck with diastasis repair (post-pregnancy, was not overweight). Had post-op fecal impaction as a complication due to meds. Have had persistent lower abdominal swelling; lower abdomen larger now than before tuck. One side has swelling 1 and a half inches higher than the other. When i lift hips up higher than shoulders on bed, grapefruit-sized ball of fluid accumulates around umbilicus and pulsates with heartbeat. Lymph drainage then swells up all other nodes, especially armpits when I do this. Abdomen is not flat at all, although I have BMI of 20. I have moved away from area where surgery was performed, but on last post-op visit (3 months), whani I asked plastic surgeon what the swelling was, he simply said "I don't know". Could this be a seroma, some sort of lymph related cyst, etc.?If I eat a full meal, this area hurts. Any ideas and could this be repaired?
From: rt, ca 05/24/2008
Response: There are a number of things which this could be and a true hernia or rent in your rectus muscle must be ruled out with a CT scan of the area. Having said that, you likely have a seroma which was undiagnosed at the time of your procedure. When the fluid is there for such a long time, the body walls it off such that it will not resorb. I have had success with liposuction of the area in order to scarify the inner lining of the cyst but, on patients of other surgeons, this did not work in their hands and I had to perform, essentially, a lower tummy tuck again with removal of the scarred material and cyst so that healing could commence "from square one" again. Suction drains must be used after this repeat procedure.
Submitted by: Dr. Gregory Caputy, Honolulu, HI Web site for Dr. Caputy
Posts by Dr. Caputy at "Ask A Platic Surgeon"
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