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3 Months Post Tummy Tuck After 250lb Weight Loss: Incision Lines Now Leaking

At Week 3 Developed a Seroma, Had Jp Drain in Till Aout 2nd Month, with Lg Output 1000cc & up/24hrs. Never aspirated, but drain out about 3-4 weeks, and now my lower abd has a football sized protruding area, numb& red. Lower incision lines have started to leak fluid. Ps does not seem to be alarmed... I'm worried about sepsis, any ideas

Doctor Answers (7)

Seroms after Tummy Tuck

+1
Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid.
Best wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
5.0 out of 5 stars 27 reviews

Recurrent seroma problem after an abdominoplasty

+1

It is most likely that you have a recurrence of your seroma.   Unfortunately these seromas are not uncommon in massive weight loss patient.  You will more than likely need to have another drain placed until this has resolved.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Seroma after tummy tuck

+1

You most likely have a seroma after your tummy tuck procedure.  This is especially common after larger tummy tucks after massive weight loss.

Persistent seromas (fluid collections) this long after a tummy tuck will most often require surgery to help them resolve.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 82 reviews

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Tummy tuck

+1

It sounds as if you have a persistent seroma. this will likely no resolve without drainage and may require a return to the operating room to eliminate the seroma cavity.

David L. Abramson, MD
New York Plastic Surgeon
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Draining fluid after tummy tuck

+1

    This does sound like a persistant, non-resolving seroma (fluid collection under the abdominal skin) that needs to be addressed.  You can have a non-infected seroma which would require the placement of a drain in the office or even a trip back to the operating room to stitch the cavity closed and leave a better drain at that time.    

    Seromas can also become infected secondarily and cause big problems.  Make sure you convey your concerns to your plastic surgeon so that he or she can tell you what they plan to do.  If you don't feel reassured, get the opinion of another surgeon. Good Luck.

Erez Sternberg, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 17 reviews

Your surgeon should be concerned

+1

You have recurrent seroma that require drainage. You may develop infection if not treated. If your surgeon does not or can not help, seek second opinion from a board certified plastic surgeon.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 56 reviews

Seroma after tummy tuck

+1

I sound like you may have a recurrent seroma though without photos it is difficult to say.  If you are leaking through your incision you should address this again with your PS as you may need to be taken back to surgery and have a drain placed and some some quilting sutures placed.

Delio Ortegon, MD
San Antonio Plastic Surgeon
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.