Is this amount of swelling normal after a TT?

I'm curious to hear how your doctor responds to the e-mail you sent.   I am swelling like crazy.  I'm glad you started this thread because it has been really good to read the experiences of others.  I'm four weeks out as of today and my waist is bigger than it was pre-op!  I had an anchor tt and 8 lbs of skin/fat removed plus muscle repair (no lipo).   I looked much smaller when I was just a week or two out than I do right now.

 

My swelling is just as awful in the morning as it is when I go to bed at night... so I am curious to know if that indicates that it isn't "normal" swelling.   It is also a bit lopsided.  My vertical scar is no longer in the middle, but rather pulled towards the right side of my body.

 

Swelling sucks.  I'm looking forward to being fully healed someday.  I know it will come.  I've decided to not do any clothing shopping until the Fall!  :)  Hopefully by then I will see my true results.

 

Hope your swelling improves quickly...

He is sending me for an ultrasound. It is the definitive way to tell if there is a seroma.

Have you had your ultrasound yet?  Sending you lots of healing (and "deflating") vibes!!

Yes, deflate me, please! I do have a seroma. The technician who performed my ultrasound this morning showed it to me. Funny thing is, she did not see it at first pass until she went all the way around the sides of my body. There she found a little collection on each side. I told her that I could not feel the seroma when I was flat on my back but that I could feel it when I stood upright. I say this because i conducted the tests that Dr Fisher posted here. sure enough, i could feel the wave of fluid as i pushed and my other hand rose as i did do. So the tech had me stand and did the ultrasound again. This time all the fluid collected in my lower abdomen. It is very wide and not too tall, almost like a sausage.

I am really glad that I am so involved in my own health. Word of advice to others to do the same. The surgeon, the PA, and even my daughter kept telling me it was normal swelling. But because of Dr Fishers' comments on my post here, i pushed the issue with my surgeon who then sent me for the ultrasound.

I do not know yet how my surgeon will treat me. I am waiting for him to review the results and get back to me.

Thanks so much for your thoughtfulness and asking how I am doing. And how are you doing?

Haha!  ***ZAP***  There, you're deflated  Oh, how I wish that worked....   :)

 

I'm so glad that you went and had the ultrasound done.  Not only that, but that you also basically helped the tech find the seroma! It is excellent that you are so involved with your own health - I absolutely agree that it is critical and I wish everyone would take charge.  No one cares about your health, or knows your body, as well as you do.    Doctors, at least the good ones, really want to partner with us to ensure the best care.    So we all owe it to ourselves to read/research/speak up!

 

I am interested to hear what your PS decides to do about the sermona.  I've heard they often get drained with a syringe (a syringe that looks far more terrifying than it actually is).

 

I'm doing pretty well, thanks.  Still very very swollen - today I am the biggest I've ever been (er, since surgery I should say).   My hips have gained about five inches from their smallest measurement... and the scale is up about six pounds from it's lowest.  *sigh*   But, I do believe mine is likely just normal swelling.  I didn't have the "wave" and when I push in one area, it doesn't inflate another.   So it sounds very different from what you are unfortunately experiencing.    I have a check-up with my surgeon schedule tomorrow, so I'll get his evaluation.    On the upside -my belly button is finally starting to look better, so hooray!!! 

 

Well, take care and I'll look forward to any future updates you share! :)

 

I do love my surgeon and think he is a very good doctor. It is just that I am in a different state now, 10 hours or more away from him. I wish that I could pop into his office and have him check me out. That would put my mind at ease.

The results of the ultrasound that I had yesterday were not going to be sent to him for 1-2 business days, which meant I could have waited all the way until Monday for the results. That would have been nerve-wracking. But the tech said that my surgeon could call the radiologist before that to discuss the findings. So I let my surgeon's office know that. And he was terrific because after being in surgery all day, at the end of the day he called and spoke with both the tech and the radiologist on the very same day that I had my scan performed. Then he called me.

So, my surgeon told me that the radiologist said the seroma was 5" wide and 1/4" deep and too small to drain. My surgeon even asked him if the radiologist would be able to aspirate it using ultrasound to guide him and he said no (the surgeon would palpate me to aspirate it and the ultrasound assisted aspiration is much more accurate).

However, when I saw the image on the technician's screen, she had a hard time fitting the entire length of the image into the photo because it was wide. I asked her how big it was and she said 70 ml but that it may not be accurate. A 70ml seroma from what I have read is too large to aspirate and would require drains. Anyway, when she said 70ml may not be accurate, I did not think it would be grossly off. Seromas of 60ml and smaller can be aspirated although I do not know how small is too small to be aspirated. So, I am wondering if the radiologist saw all of the images. It was only the images of me standing that showed the seroma at it's full size. After all, even the very best and brightest people make mistakes from time to time; no one is infallible.

With the way that I can now push the fluid around from one side of my body to the other side and up from my pubic mound into my abdomen, I really feel like something is not right. So, I have made an appointment to see another plastic surgeon here where I now live so that  I can show him how I can push the fluid around and he can tell me it is normal or tell me it needs to be drained. He is at the same university hospital where I had my ultrasound done and will be able to see those records, as well.

Getting back to my surgeon, I was so shocked when he told me the seroma was too small to be drained (plus I was distracted because I was driving my car when I took the call) that I did not think to tell him how I can push the fluid around. I just said that I was left with a very different impression from the technician. And now I don't want to call him back and reha**** I don't want him to think I am nuts because I have called/emailed/text him so many times since my surgery to ask about bleeding and swelling (no one had told me that bleeding from the drain site was normal or that there would be this amount of swelling so each time it happened I was concerned). He has always been prompt and polite in answering my questions and allaying my concerns. So I do not want there to be a situation in which I really need him emergently and, like the boy who cried wolf, I am no longer heard.

I read on another forum of a woman who had a seroma that went untreated for so long that now she needs another tummy tuck to address it. I do not want something unusual like that to happen to me. I have worked in the pharmaceutical industry my entire career and am keenly aware of the many adverse events that can happen with any treatment and how hard it is for doctors to keep up with everything because they are on overload. So this really keeps me on my toes when it comes to my health and the health of my loved ones. In fact, I "diagnosed" my mother with a rare form of dementia that many specialists had missed diagnosed. I then took her to a dementia specialist who confirmed I was correct. 

Maybe I am concerned over nothing but I'd rather do the thing that is safe instead of taking a risk. 

Hi.
Dr Fisher again. A 70cc seroma is small and will often resorb by itself. I usually attempt aspiration. If I fail and it gets worse or does not get better, I try again. If there is no discomfort the seroma usually resolves itself. I very rarely drain them. They have to be usually more than 3 to 4 hundred cc. Chronic seromas can be a problem extremely rarely requiring excision under anesthesia in the OR.
If you are very swollen with no seroma I will sometimes start you on a low dose of Lasix ( a diuretic ) .
Let me know if any of you have any other questions.
Dr Peter Fisher.

Dear Dr. Fisher,

You are terrific. Thank you for your thoughtful reply. It just goes to show that you cannot believe everything that you read on the Internet. Thanks so much for clarifying -- I had read that seromas over 60ml (or cc) were too large to be drained. 

I am wondering what is going on with my body because it feels like more and more fluid is pooling. I definitely can pu**** around more than I could previously. If I push up on my pubic mound I can feel the wave like movement you described on both sides of my lower abdomen, all the way out above the pelvic bones. It feels like an air bubble inside fluid on each side. The same thing happens if I push anywhere on my abdomen at or below the belly button. Last night as I lay in bed, slightly on my left side, that part of my tummy became lop-sided, as if all the fluid was pooling there. When I turned slightly on my right side, the same thing occurred.

So, here is what is running through my imaginative mind. The entire area below my naval down to my pubic region and out to my hip bones is not having the skin fuse properly to the tissue and that is why I can push this fluid around. 

Thank you. I very much appreciate your help and assistance.

I believe you are correct. You need aspiration. If that works and it comes , do it again. You eventually may need to add a sclerosing agent to help fuse the tissue together.
Dr Peter Fisher.

Dear Dr. Fisher, thank you for listening to me. I truly appreciate that you took the time to come back again and again to help me. And it helps to finally hear an MD acknowledge that something may be wrong. Thanks again for your generosity with your time. If you would take this much time to help someone on a forum, you must be wonderfully supportive of your patients.

Thank you again.