After gallbladder surgery, your stomach will typically have four small incision marks scattered across your upper abdomen, along with noticeable bloating, bruising, and adhesive strips or stitches at each wound site. The appearance changes significantly over the first few days and weeks, so what you see on day one looks very different from what you’ll see at the six-month mark.
Most gallbladder removals today are done laparoscopically, meaning the surgeon works through small ports rather than one large cut. That’s what determines the pattern of marks on your abdomen.
Where the Incisions Are
The standard laparoscopic technique uses four port sites, sometimes called the “10-10-5-5” configuration based on the size of each instrument in millimeters. The largest incision sits at or just below your belly button, where the camera goes in. A second incision of similar size is placed in the epigastric area, which is the upper center of your abdomen just below the breastbone. Two smaller incisions are made on the right side of your abdomen: one beneath the ribs and another further down along the right flank.
Each of these cuts is small. The two larger ones are roughly 1 centimeter (about half an inch), and the two smaller ones are about half a centimeter. They’re closed with stitches, surgical staples, or adhesive strips depending on the surgeon’s preference. Some surgeons use skin glue, which leaves a thin, shiny film over the wound. You’ll often have small white paper strips (steri-strips) beneath a clear dressing at each site, which you can remove about a week after surgery.
If you had open surgery instead, the appearance is quite different. An open cholecystectomy uses a single incision along the right side of the abdomen, tucked just under the rib cage. This cut is typically 8 to 12 centimeters long, roughly 3 to 5 inches, and is closed with staples or stitches that are removed at a follow-up visit.
Swelling and Bloating in the First Week
One of the most striking things about your stomach after laparoscopic surgery is how swollen it looks. During the procedure, the surgeon inflates your abdominal cavity with carbon dioxide gas to create space to work. That gas doesn’t all escape when the surgery ends. Some remains trapped, and your body absorbs it gradually over the next 24 to 72 hours. In the meantime, your belly can look and feel noticeably distended, almost as if you’re several months pregnant.
This bloating is completely normal and usually the most uncomfortable part of recovery. You may also feel sharp, referred pain in your shoulders, which happens because the residual gas irritates the diaphragm. Walking around helps your body clear the gas faster. By the end of the first week, most of the gas-related swelling has resolved, though some puffiness around the incision sites can linger.
Bruising Around the Incision Sites
Bruising around the port sites is common and expected. In the first 48 to 72 hours, you may see purple, blue, or yellowish-green discoloration spreading outward from one or more of the incisions, particularly the belly button site and the epigastric port. The bruising can look alarming, especially if it spreads several inches from the wound, but this is a normal response to the tissue manipulation during surgery.
The belly button incision tends to bruise the most because it’s the largest port and the area where the gallbladder is extracted. The bruising follows the same color progression as any bruise: dark purple or blue initially, shifting to green and yellow over a week or two before fading entirely.
What the Scars Look Like Over Time
In the first few weeks, the incision sites look pink or red, slightly raised, and possibly a bit crusty as they heal. You may notice tingling, numbness, or itching around each wound. A hard, lumpy feeling beneath the skin is also common as new scar tissue forms underneath. This is all part of normal healing.
Over the following months, the scars gradually fade from pink to a pale white or silver color. The belly button scar often becomes nearly invisible because it’s hidden within the natural folds of the navel. The epigastric scar, sitting higher on the abdomen, tends to be the most visible long-term, though at roughly 1 centimeter it’s still quite small. The two right-sided scars are typically the faintest, given their smaller size. By six months to a year, most people find their scars have flattened and blended into surrounding skin enough that they’re easy to miss.
Surgical Drains: When They’re Used
Most laparoscopic gallbladder removals don’t require a drain, but in complicated cases, your surgeon may place a Jackson-Pratt (JP) drain before closing. This is a thin tube that exits through or near one of the incision sites, attached to a soft, squeezable bulb that collects fluid. The bulb is about the size of a grenade and sits outside your body, usually pinned to your clothing below the exit point of the tubing.
The fluid it collects is typically pinkish or straw-colored. You’ll need to empty and compress the bulb a few times a day to maintain suction. JP drains stay in for anywhere from a few days to a few weeks, and the surgeon removes it once the drainage drops below about 25 milliliters per day for two consecutive days. The drain site leaves one additional small scar.
Longer-Term Bloating After Recovery
Beyond the initial surgical swelling, some people notice their stomach looks or feels different in the weeks and months after gallbladder removal, even once the incisions have healed. Without a gallbladder to store and concentrate bile, your digestive system handles fat differently. Bile now drips continuously into the small intestine rather than being released in a concentrated burst after meals.
This change can cause bloating, gas, and a visibly distended abdomen after eating, particularly after fatty meals. Other symptoms include diarrhea, nausea, and indigestion. This collection of digestive changes is sometimes called postcholecystectomy syndrome, and it can appear in the early recovery period or develop months to years later. For most people, the symptoms are mild and improve as the body adjusts, though some find they need to permanently reduce fat intake to stay comfortable.
Signs Something Isn’t Healing Right
Normal healing involves mild redness, slight swelling, and some tenderness at each incision site. What isn’t normal is redness that keeps spreading outward from the wound, especially if it’s warm to the touch. Discharge from the incision is another signal to watch: clear or light pink fluid in small amounts is fine in the first day or two, but thick, cloudy, or foul-smelling drainage suggests infection.
Other warning signs include wound edges pulling apart, skin that looks dusky or darkened around the incision, increasing pain rather than gradually improving pain, and blistering or blackish discoloration at the wound margins. Excessive swelling or a firm, tender lump beneath one of the incisions could indicate a hematoma (a pocket of collected blood) or seroma (a pocket of clear fluid), both of which may need to be drained.