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Difficult to Drain Seroma Post Tummy Tuck, Hysterectomy, Liposuction Followed by Emergent Cholecystectomy?

GB out emergently 20 days PO via lap. Now difficult to drain seroma. POD 3= seroma so PS aspirated w/ 20g; saw the wave but very little fluid. Tried drain placment-nothing. Got readmitted a day later for cont'd elevated LFTs w/ N and V. US guided drain didn't work b/c pocket too small and collapsed when aspirated 50 ml in two diff areas. 3 more US drain,same thing. Not able to drain it all. Now 6 wk, ongoing. Don't have thick fat layer. Extensive US, no lg pocket just a few smaller ones. Advice?.

Doctor Answers (7)

N Seroma Post Tummy Tuck, Hysterectomy, Liposuction Followed by Emergent Cholecystectomy

+2

Other than re-opening the incision and placing drains, it seems like everything else has been tried. Usually these small fluid collections will resolve spontaneously. They are probably more common than we know because very few patients get post op imaging studies. 

Unless these are visible or symptomatic, I would favor no treatment. If any are drained in the future, injecting a sclerosing agent, such as betadine, tetracycline or alcohol should be considered. 

Thank you for your question, best wishes. 


Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

Difficult to drain seroma post tummy tuck, hysterectomy, liposuction followed by emergency cholecystectomy?

+1

Unfortunately, I would suggest surgery. Since your plastic surgeon and radiologist have been unable to drain the seromas, I would suggest more aggressive treatment. This would require general anesthesia and opening of the abdomen again. Typically, these seromas can be directly excised and should not come back. I would suggest placing drains for 7 to 10 days and would suggest post operative compression for two months. I hope this helps. Good luck. Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 27 reviews

Seroma after Gb after Tt

+1
The best laid plans. So sorry to hear that your gallbladder had to come out so soon after your tummy tuck. It sounds as if you have been through the wringer. I, too, would not recommend intervention and would favor conservative monitoring. Small seromas will hopefully resolve gradually. Best of luck to you.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

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Post operative seromas following an abdominoplasty

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    You have had quite a series of events.  I am glad you are doing better and the seroma has been drained.

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Interventional radiologists can drain seromas after tummy tuck.

+1

Hi.

I recommend another opinion.  You have had a very complicated course, and I would not ignore these seromas.

George J. Beraka, MD (retired)
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Chronic seromas after tummy tuck surgery sometimes need surgery

+1

From your description, it sounds like this troublesome fluid pocket is becoming a 'chronic' seroma. In cases like yours, I have never regretted returning to the operating room and actually excising the entire seroma cavity and closing the abdomen over drains. Discuss this option with your plastic surgeon.

Scott C. Sattler, MD, FACS
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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.