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After 4 Weeks Discovered I Had a Seroma

After 4 weeks post op from a tummy tuck, I was told I had a seroma at my 4 week post op appointment. The PS had to drain the area using a needle and syringe. The Doctor ended up draining 600cc of fluids. A week later, I see the fluid has come back and it looks like it is going to be quit an amount that needs to be drained again. How many times will I need to get this drained? will this effect the outcome of my Tummy tuck results? IS this slowing my healing process? What am'I doing wrong?

Doctor Answers (12)

It should be drained frequently

+5

Hello,

A seroma is just a collection of healing fluid but if present for large periods of time it can form a pseudo-bursa which is essentially scar tissue that can result in fullness in the area.  I would have it drained 2-3 times per week and wear your abdominal binder religiously.  The other option is to have your plastic surgeon place a seroma catheter or drain.  You should be wearing your abdominal binder essentially around the clock except for showers.  Doing so will help the two sides of your tissue heal together and get rid of the seroma.  I have listed a web link regarding pseudo-bursa formation below if you need additional information.

All the best,

Dr Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 87 reviews

Seroma drainage

+2
If you have a postop seroma, it may need to be drained on more than one occasion. The alternatives are to drain during office visits or to place a catheter. Each plastic surgeon has his or her own protocol as to how to handle drainage. You haven't indicated whether drains were initially placed during your operation. I always use the drains to reduce the risk of seroma. Obviously, the drainage is a nuisance but it should not affect the outcome of the abdominoplasty. Please be patient and comply with your plastic surgeon's instructions. Speedy recovery!

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Seromas after tummy tuck

+2

600cc is a lot. 4 weeks after surgery is late to find this out. You should probably be returning to office even twice a week to get a handle on this. If it doesn't dramatically improve within 2 weeks I would put in a drain. If a seroma is not adequately treated the undersurface of the skin may never "stick" back down, in which case you may always have a bit of fluid, and therefore fullness which remains.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 23 reviews

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Seroma after Tummy Tuck

+2

Thank you for the question.

Seromas are a relative frequent occurrence after tummy tuck surgery. It appears that your plastic surgeon is treating it appropriately with the repeat aspirations. Often larger volume seromas  like yours may require several aspiration treatments. The presence of the seroma does not necessarily mean you're doing anything “wrong” and it will not necessarily affect the end results of your tummy tuck surgery.

I would suggest continued follow-up with your plastic surgeon and ask him/her about your activity level ( this may or may not be related to fluid accumulation).

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 701 reviews

Tummy Tucks and Seromas

+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.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

Seroma collection after an abdominoplasty

+1

If you have a  bulge at 5 weeks after your surgery it is either, a seroma, a hematoma, residual fat or muscle bulge.  Your plastic surgeon is in the best position to help decide what the problem is and how to correct it.  If the fluid keeps collecting then a drainage tube may have to be re-inserted.

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

Seroma after tummy tuck.

+1

A seroma after a tummy tuck is a common complication. Because the abdominal skin is lifted off of the abdominal muscle wall, there is a space between them where fluid can collect. Shearing forces can disrupt the scarring process which reattaches these two layers and the result is typically a seroma or fluid collection. The fluid may need to be aspirated multiple times over several weeks before it goes away. Wearing a compression garment can help prevent or reduce reaccumulation of this fluid. The problem with a seroma is that if the fluid stays in place, your body will build a scar capsule around it and it will never completely go away. By aspirating it, you give the body a chance to seal off the space which ultimately prevents further reaccumulation. Sclerosing agents can be injected into the space to help this scar tissue form, but in certain cases it takes a revision operation to correct.

There are several ways to limit the possibility of a seroma including surgical "quilting" sutures during the operation, leaving the loose lymphatic tissue on top of the muscle wall intact, and strict use of postoperative garments. Still, despite all of these manuevers, seromas continue to be a concern.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 11 reviews

Late seroma after tummy tuck

+1

This is a very large seroma volume. If you were my patient I would place another drain rather than aspirating the seroma 2 or 3 times a week. But if you do not mind the repeated aspirations that is certainly a reasonable option.

Ann F. Reilley, MD
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 6 reviews

After 4 Weeks Discovered I Had a Seroma

+1

You might request to have a drainage system placed operatively to alleviate the need of needle aspiration. Just a thought. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Large seroma first noted 4 weeks after tummy tuck

+1

Seromas are a frequent occurrence with tummy tucks and the majority of plastic surgeons use drains to reduce their incidence. However, 600cc is a massively large seroma that took a relatively long time to accumulate. Depending on several factors, this can be treated with repeated but frequent aspirations that should be performed 2 - 3 times per week - once a week is inadequate. If the amount of aspirations each time doesn't show a trend to significantly reduction then placement of a drain should be considered. This usually can be performed in the office.

Given the volume that you have experienced, it may be prudent to pursue this course of action. A seroma that persists for a prolonged period of time can become a chronic problem due to the fact that the body forms a sac that sometimes needs to be removed with surgery.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 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.