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Could Distended Lower Abs After Tummy Tuck Be A Seroma?

I am 5 weeks post tummy tuck. My upper abs are very flat but right below my incision is extremely distended . It's as though I have a donut around my belly. My PS says this is where the swelling naturally travels but I keep wondering if it is a seroma. I cannot find pictures of a seroma on the web. the area is even all the way around . I cannot fit into my old clothes and am worried. Please help.

Doctor Answers (8)

Fluid feel of seroma after tummy tuck

+3

A seroma will feel full and heavy and typically have a fluid wave as you tap over the full area. Swelling is more stiff and spongy. If there is doubt, your surgeon can aspirate the area to see if a fluid collection is present.

Best of luck, peterejohnsonmd.com


Chicago Plastic Surgeon
4.0 out of 5 stars 29 reviews

Swelling after Tummy Tuck Surgery?

+2

Thank you for the question.

As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.

Abdominal wall "swelling" after tummy tuck may be related to:

1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.

2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary. 

3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.

4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  a complete skin redraping  to occur.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 751 reviews

Distended after tummy tuck

+2

It is perfectly normal to have some swelling at this stage, however you could very well have a seroma.  It is impossible to say without seeing you.  A seroma is a fluid collection that will often feel water balloon like when you push on it.  Sometimes you can push on one side and feel a wave of fluid move around the tummy.  I would have your surgeon look at it because I don't think photos will tell you one way or another.  Good luck!

Tiffany McCormack, MD
Reno Plastic Surgeon
5.0 out of 5 stars 21 reviews

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Swelling vs. seroma?

+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 28 reviews

Swelling versus seroma

+1

Hello,

Thank you for the question.  At 5 weeks out after your tummy tuck even fullness below your incision line can be either swelling or a seroma.  Your plastic surgeon can evaluate you best to determine which of these issues is occurring.  Sometimes an ultrasound or a CT scan is needed to evaluate for a pseudo bursa but more often the physical exam is sufficient.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 95 reviews

Seroma?

+1

It is possible, but less likely at 5 to 6 weeks after surgery. Positioning , garment use, and activity levels all can affect the swelling -and therefore early appearance of your abdomen at this time frame. I f you see a "wave' under the swollen area when you push on the skin- then it may be a seroma. Best to follow up with your surgeon.

William Loutfy, MD
Albuquerque Plastic Surgeon
5.0 out of 5 stars 16 reviews

Seroma

+1

If you have a seroma in the lower abdomen, there is often a fluid shift that is palpable. You may even be able to shake and feel fluid move around.

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

Seroma?

+1

This could represent normal swelling or a seroma.  If it is flatter in the morning, but distends more during the day, it is more likely swelling.  If it stays the same during the day, it may be a seroma.  A fluid wave as described below indicates a seroma.  An ultrasound can be done if there is a question.  Sometimes in people with thicker tissue, it is difficult to feel a fluid wave and they can have a seroma that is difficult to diagnose.

Donald Griffin, MD
Nashville Plastic Surgeon
4.5 out of 5 stars 19 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.