What is this liquid pouch above my scar?
You've had surgery and are well on your way to recovery, but there's this frustrating spot just above your scar that just seems to still be stubbornly full of fluid. It feels like there's a water balloon under your skin-- a small pouch that feels more like fluid than fat.
First of all, know that this is extremely common and totally normal. If you have just had a tummy tuck, this is basically expected, though it can easily happen with scars in other locations too. It doesn't mean anything horrible, so let's dive in to why it's there and what to do about it.
What causes it
When your skin is cut and then stiches itself back together, the skin and circulatory system do a great job at healing, but the lymphatic system is not quite so good at bouncing back. Pretty much, if lymph passageways get interrupted as some point in their path, those tiny vessels will never reconnect. The good news is that you have so many lymphatic vessels running through your body that you can lose some without any major consequences. It just means that when your body has more fluid in the tissues to deal with, it may take a bit longer to get processed. If the damage happens to be in a place where major lymphatic pathways run through (under the breasts like in breast reduction or augmentation, or between the hips like in a tummy tuck or cesarean section), then that area is going to take extra long to be able to catch up and drain away extra fluid.
Is it permanent?
The fluid pouch is not likely to be permanent, though you may need a little outside help to encourage it to go away. Lymph drainage massage done by a trained professional can help your lymphatic system function at a faster rate to make up for lost vessels. This gentle, hands-on therapy will get the fluid moving so your body can process it in a matter of weeks rather than months.
What if its lumpy?
If you feel like the area is starting to feel a bit stiff, lumpy, or like the fluid inside it is thickening, don't worry, lymph drainage will still help. You may need to bump up your fluid intake if you haven't already, and start moving around more to gently work the muscles in the area once your surgeon says it's safe to do so. Those measures, paired with lymph drainage massage for a few weeks will help clean out the hardening fluid and prevent fibrosis from forming in the area. If some scar tissue has started to form in the swollen area under the skin (meaning not just the incision site) your massage therapist will likely want to do some myofascial release work too once the swelling has gone down.
Will it ever come back?
That type of swelling should really only reappear if you are dealing with more fluid retention than usual. You might notice that when you are stuck sick in bed, or on your period that some fluid will begin to pool up in that area a little bit. This is just because when the demand on your lymphatic system is a little bit higher, it may struggle to keep up. These resurgences will likely be very minor and go away on their own in a few days and won't be anything near as intense as what you experienced just after surgery.
When should I worry?
As a general rule, some indications that something may be wrong is if you notice that the area has become more tender or hot since you first got out of surgery. That would be a good time to call up your doctor and have them check things out. Also, if you notice a strange change in coloration in the area, go ahead and reach out to them. Better to hop on something early and get it taken care of than to wait because you are too nervous about "bothering" your doctor with your questions.
Though I am trained in working with the lymphatic system and certified to do Manual Lymph Drainage, I want to be clear that I am not a doctor and my advice should not take the place of a doctor's advice. Don't be afraid to talk to your doctor about your questions and concerns. It's their job to monitor you and make sure you heal up well and that they keep on top of any possible complications.