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TT - How to Know if Fluid Starts and What Happens if Not Treated?

I travelled to have a TT as I had no choice. I am 2 weeks and have a bulge under my belly button which I assume is swelling and know is normal for 2 weeks. Since I have to self diagnose- how would I know if this was seroma or hematoma? Also, if it was fluid, what would be the consequence of not treating either fluid? I plan to see my PS in about 3 months. My binder is really tight above my belly button but quite comfortable below- could this have an impact? I'm questioning whether I'll be flat

Doctor Answers (6)

Fluid Collection after Tummy Tuck Abroad

+2

Regarding: "TT - How to Know if Fluid Starts and What Happens if Not Treated?
I travelled to have a TT as I had no choice. I am 2 weeks and have a bulge under my belly button which I assume is swelling and know is normal for 2 weeks. Since I have to self diagnose- how would I know if this was seroma or hematoma? Also, if it was fluid, what would be the consequence of not treating either fluid? I plan to see my PS in about 3 months. My binder is really tight above my belly button but quite comfortable below- could this have an impact? I'm questioning whether I'll be flat
"

Physical examination skills cannot be imparted with a short electronic message. Neither can the surgical judgment and skills required to treat you. Odds are that you have a fluid collection or seroma but without an examination it would be an educated guess.

Seromas MUST be drained BEFORE they become either infected (becoming an abscess) or chronic (in which case the smooth walls will not adhere and you end up with a bursa). This cannot wait 3 months and must be done as soon as possible. You should NEVER consider doing it yourself. It must be done by a surgeon or radiologist who know what they are doing.

Dr. Peter Aldea


Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Post-operative fluid build up after tummy tuck

+2

I do not think its a post-operative hematoma.   If so, it would be purplish or dark and painful.  This is most likely a post-operative seroma that is common and can develop from serous fluid accumulation in the lower abdomen. The reason that drains are used typically after a tummy tuck is to drain the fluid that builds up.  When they are removed, sometimes fluid will accumulate internally.  If it is a small amount, then the body will usually absorb it back on its own.  If it is somewhat larger then it will stay stagnant until it is drained. It can become infected, or if it is there chronically it can become "encapsulated" and require surgery to remove.  The treatment is simple. The surgeon places a small needle through the skin and drains the fluid. Often this needs to be done serially on more than one occasion (usually weekly).  It is not painful because the area is usually still pretty numb several weeks after surgery. I would recommend going to see a board certified plastic surgeon to evaluate soon!

Sincerely,

James F. Boynton, M.D., F.A.C.S.

James F. Boynton, MD
Houston Plastic Surgeon
4.5 out of 5 stars 19 reviews

Initial Swelling is common after Tummy Tuck

+2

Swelling under the belly button two weeks after Tummy Tuck surgery is very common.

Buildup of a fluid pocket will usually present as a growing area of swelling that is getting bigger day-by-day. A tell-tale sign of a fluid buildup is a "water-bed" motion of the tissue area where a wave of fluid sets up after pushing on the area. From your picture, probably you don't have fluid buildup or what is called a seroma, but it is not possible to tell for sure.

In my Denver plastic surgery practice, we have incorporated peri-operative massage therapy into all of our Mommy Makeover, Tummy Tuck and Body Lift procedures:

Perioperative Massage Therapy

First two postoperative visits--our massage therapist performs light-touch lymphatic massage and this can dramatically reduce the type of swelling you have.

Additional massage therapy appointments--when possible, we schedule additional appointments and have found this to be very helpful for both treating the tissue and teaching patients about self-massage (we have incorporated "foam roller" therapy and scar massage techniques for our patients).


My suggestions for you at this point would be to (1) consider seeing a therapist trained in lymphatic tissue massage and (2) email you picture and question to your surgeon for their response. From your picture, it looks like you are probably headed for a nice result!

Hope this helps,

Nick Slenkovich MD, FACS

Nick Slenkovich, MD
Denver Plastic Surgeon
5.0 out of 5 stars 46 reviews

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Seroma and 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 27 reviews

Don't self-diagnose. See a PS

+1

There is a possibility that you just have swelling, but don't rely on self diagnosis alone.  You don't mention whether you had drains after surgery, but even if you did it is possible for fluid to build up under the abdominal flap.  Tap lightly on one side of your lower abdomen and watch to see if there is a fluid wave across your abdomen (not a jiggle; a wave).  If there is then you have a seroma.  It needs to be drained.  Usually it has to be done more than once which is a problem given your geographic circumstances.  You should contact your surgeon immediately and send photos (even a video of the tapping maneuver).  He or she can advise you on what to do and who to see, but plan on seeing someone about it soon (within days).  Three months is way too long to wait.  If you have a seroma and it is not drained your body will form a scar tissue capsule around the fluid similar to the one that forms around breast implants.  Once that happens the abdominal tissue won't stick down to the muscle and will lie loosely across your lower abdomen.  Surgery could be needed to correct it so act now

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 11 reviews

TT - How to Know if Fluid Starts and What Happens if Not Treated?

+1

Thanks for posting the photo. Yes you have retained fluid or a seroma. It MUST be drained! Seek medical aid. Risks are becoming infected. Sorry, From MIAMI Dr. Darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 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.