Abdominal Irregularities after a Tummy Tuck in Thousand Oaks: One Week After Surgery

A 45-year-old woman from Thousand Oaks, California, presented to my office for a second opinion after a recent abdominoplasty ("tummy tuck")....

I lost 125 lbs.  Seven days ago, I had a full tummy tuck.  Now, I have a knot directly under my rib cage, to the left of the belly button.  It hurts when I get up or cough.  I have had groin hernias in the past, and it feels similar.  Could it be another hernia related to the tummy tuck?  What can I do?

There are many causes for painful abdominal irregularities one week after an abdominoplasty....

• irregular swelling (such as from inappropriately wearing a post-operative garment)
• seroma (which is a benign fluid collection, such as from a malfunctioning drain)
• hematoma (which is a blood collection, usually from inadequate control of bleeding during the operation)
• inadequate fat excision or liposuction (which is an artistic error)
• fat necrosis (which refers to death of some fat cells, usually from poor blood supply, and which sometimes occurs in obese patients and in smokers)
• abscess (which is an infected collection of pus, and which can result from a seroma or hematoma, but more often than not, is the result of bad luck)

The term hernia refers to a defect in the muscles of the abdominal wall.  This "hole" allows internal organs to protrude out from the abdominal cavity.  A hernia would be unusual at the described location.

Most of the common causes of early, painful irregularities after a tummy tuck can be managed without additional major surgery.  Aspirations (using needles to draw out fluid) and antibiotics are the mainstays of management.  Occasionally, however, returning to the operating room is the most effective way to control acute problems.