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Recommendation on Draining Seroma After Tummy Tuck?

Now 4 weeks post session, a seroma has developed (according to my dr.) I go weekly and she doesn't want to irrigate because of the risk of infection.

The first drainage removed 130cc of fluid from the lower section (under belly button to above pubic bone). The second aspiration removed 135cc from the lower section and 30 from the upper above belly button and below breasts.

Also, I have an appearance as though I have an elastic band belt around my mid-abdomen (belly button). The fluid keeps coming. Help! Advice?

Doctor Answers (4)

Seroma after abdominoplasty

+3

Unfortunately, seroma after abdominoplasty is not uncommon. Most of the time, they can be treated with serial aspiration in the office. 135cc is really not a lot of fluid and I would anticipate that your problem will resolve with the present regimen, not requiring anything more agressive.

Rarely, seromas become refractory and can be injected with various agents (eg.tetracycline) to try to get the shallow wall of the seroma to stick to the deep wall, thus obliterating the space. Sometimes reoperatin is needed to excise the seroma if other therapy fails.

The odds are very much in your favor for a good resolution without more than serial aspiration.


Atlanta Plastic Surgeon
4.5 out of 5 stars 10 reviews

Seromas are quite common after tummy tuck

+3

Seromas are one of the most common complications after tummy tuck. In most cases, provided they don't become infected, they're nothing more than a nuisance. Your surgeon is performing serial aspiration of the fluid collection, which is a very accepted practice. I'll combine this treatment with an abdominal compression garment, which can help limit re-accumulation of fluid. Even with this, it may take several aspirations over many weeks before the fluid stops collecting.

Try not to make any conclusions about the appearance of your abdominal wall yet. Only 4 weeks after surgery, you still have a significant amount of swelling of the abdominal wall. In combination with a seroma, this will lead to a very distorted appearance. Once your seroma is gone, and a few more months have passed, your abdominal wall will undoubtedly start looking better! Best of luck!

Sam Jejurikar, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 33 reviews

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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

I would recommend inserting one or two drains.

+1

Hi!

Seroma is the most common complication following a tummy tuck, and it is best treated aggressively.

We work with an interventional radiologist, and we would send you for ultrasound guided aspiration of the seromas and insertion of drains, which we would keep in at least 2 weeks.

Seromas can lead to permanent deformity, so they are potentially serious.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

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