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Seroma After Tummy Tuck - Non Surgical Removal?

I had an abdominoplasty a year and half ago resulting in a seroma 10x15 cm. Is there a solution after this time to remove it without surgery?

Doctor Answers (16)

Seroma and Tummy Tuck

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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.  Seromas can be aspirated instead of surgically removed and a tight compression garment placed, however this needs to be done often and until it is gone.
Best wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

Seroma after a tummy tuck

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This sounds to me like you will need another operation to correct the seroma cavity since the cells lining it are probably still producing fluid and need removal.  Best wishes

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 50 reviews

Seroma one year after a tummy tuck

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A tummy tuck is a safe and effective procedure to contour the abdomen, create a tight waist, and remove extra skin, fat, and stretch marks. Patients should expect a significant recovery process after the surgery. However developing a seroma one year after your surgery can be unusual. At this stage, your best bet is to return to your board-certified plastic surgeon and let him evaluate your abdomen and this new collection. They will appreciate the opportunity to help you achieve a great result. Depending on the size and location of the seroma, your surgeon may recommend percutaneous drainage, a small incision and drainage or a small procedure to remove the tissue that is creating this fluid. Be sure to bring in the compression garment that you have used after the surgery as applying immediate and constant compression after your surgeon removes this collection is essential to prevent the recurrence of this seroma.

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 65 reviews

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Non-surgical treatment of Seroma

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Non-surgical treatment of the serma could be carried out with placement of a seromacath or having the interventional radiologists place an indwelling seroma catheter and/or considering slcerotherapy.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Seroma & pseudobursa

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It sounds like you have a "pseudobursa", which is a fluid-filled sac beneath the skin.  These can happen with long-standing seromas.  The only answer I know to fix this is to operate, fully excise the sac, and place drains, or do internal quilting sutures.

Seromas seem to be more common in tummy tuck patients that also have liposuction of the abdomen or flank areas, and in the massive-weight loss population.

 

Best wishes,

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 25 reviews

Treating an established seroma

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Seromas (fluid collections) occur in ~ 5% of abdominoplasty patients.  Generally, they can be treated with needle aspirations in the office followed by wearing compression garments.  Rarely, seromas persist several months.  If they do, often surgical removal is the only option as the lining that forms the fluid cavity needs to be removed.  Another nonsurgical option is to place a drain in the fluid cavity and inject a sclerosing agent that may help the lining scar in place and collapse the space.

Naveen Setty, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Seroma long after tummy tuck.

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While seromas can occur after a tummy tuck, most are self limiting and respond to serial aspirations and continuing the abdominal binder.  Once they have persisted as long as your has, there is a lining to the seroma which prevents it from resolving.  The next least invasive procedure would be to place a drain and try to sclerose the lining of the pocket with a concentrated antibiotic solution.  If this does not resolve it, surgery may be needed to remove the lining.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 32 reviews

Seroma after one year

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If you have a seroma after a tummy tuck one year after surgery, you probably have a pseudobursa that has formed and will need sugery to remove it.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Treating the established seroma

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Once the pocket has had time to line itself with tissue like the inside of an oyster, there is no treatment that will resolve a seroma other than surgery.  Prior to that, serial aspiration and sometimes secondary drain placement is necessary.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Seroma after Tummy Tuck

+1

At a year and a half after tummy tuck, it is unlikely for your seroma to resolve on its own.     By this point, the seroma has formed a capsule that will need to be resected to allow the cavity to collapse.

If seroma is recognized in the immediate postoperative period, it is important to consider percutaneous needle drainage and compression garments to prevent recurrence.   If this fails to treat the problem after repeated attempts,  I recommend insertion of a seroma catheter and possible injecting a sclerosing agent to help collapse the seroma cavity wall.   If all of the above fails, surgery may be indicated to remove the capsule and prevent longterm sequelae.

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 35 reviews

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.