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What Next, 3 Wks Post Tum Tuck with Newly Formed Fluid Collection?

Just to make it easier, i am a healthcare professional, had tum tuck 3 wks ago, with post op 2 drains, one removed at day 9 and one yesterday at day 14, in spite of it was draining 60-80 cc/day. The decision to take out made with my PS. Today there are swelling in the flanks and lower abd, it fits fluid collection, unlikely hematoma, as there are no bruises. now My DDx either seroma or inflamatory fluid, what shall I do, shall I aspirate it out, i can do that at home as my PS in different provin

Doctor Answers (7)

Management of Fluid collection after tummy tuck?

+2
Your dilemma results from earlier decisions. Relax, this is not life threatening, and should not compromise your result if appropriately managed. The seroma can be treated by serial aspiration, drain re-insertion, sclerosis, and/or re-operation. My advice, and likely the advice of your surgeon, don't drain this yourself.... Although, I must admit, if it were me, I'd probably be freezing daily with ethyl chloride and, with sterile technique, be draining with 18g needle into 60cc syringe with 3 way stopcock. Call your surgeon and develop a plan.


San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

What Next, 3 Wks Post Tum Tuck with Newly Formed Fluid Collection?

+2

From my perspective, the drains were removed too early. Seek re insertion ASAP otherwise continual needle aspiration will be your course. As for self aspiration ONLY if the situation is desperate. 

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

Seroma Formation three weeks after a Tummy Tuck

+2

It appears you have a seroma and that your drains may have been removed too soon. Even if you are a fellow surgeon, it would be inappropriate for you to aspirate your own seroma. I would suggest you ask your Plastic surgeon to help find a colleague closer to you to take over and do several serial aspirations of the seroma. In most cases, aspirating these every few says would resolve the seroma. If this does not work, ytou may consider ultrasound-guided placement of another drain. In very rare cases, seromas which do not resolve despite all measures may require a re-operation. With prompt care this is not apt to happen.

 

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

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Tummy Tuck and Post Operative Fluid Collection

+2

At 15 days post tummy tuck and just having had the drains removed, I believe you are correct the what you are experiencing is the formation of a seroma.  Under no circumstances should you attempt to aspirate this seroma, yourself.  Even if you are a health care professional and practice sterile technique, you could have a complication - loss of blood pressure, faint, etc - and risk significant injury.  Contact your plastic surgeon, and if, he is not in your local region, ask him/her for a local, qualified physician who can evaluate and treat you.  Best of luck.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
5.0 out of 5 stars 16 reviews

Tummy tuck and Seroma?

+2

Thank you for the question.

Your description fits perfectly with the presence of a seroma.  you should be evaluated by your plastic surgeon who will using sterile technique aspirate the seroma for you. Sometimes this aspiration ( which tends to be painless) needs to be repeated a few times.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Treatment of a seroma after a tummy tuck

+1

Your fluid collection is clearly a seroma and this was quite predictable with the amount of fluid your drain was putting out just prior to removal.  Your best choice at this time is to have another drain inserted which could be accomplished percutaneously under local anesthesia by a general surgeon or a radiologist with ultrasound guidance. Serial aspiration is an option but I would not recommend that you try it yourself.

James McMahan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 11 reviews

Seroma After Drain Removal From A Tummy Tuck

+1

The development of a seroma after a tummy tuck is not a rare problem, despite having had drains in up to two weeks after surgery. While you can make an argument now that the drains were removed too early, most patients have little tolerance for them beyond a few weeks. Regardless, that is an irrelevant issue now. You need to get the area aspirated to remove the fluid and this will have to be done probably a few times before the fluid collection ceases. Usually patients will need to be tapped once a week until it stops accumulating. While it would be best to have a doctor doing the aspiration, I have had a few nurses over the years who were comfortable doing their own aspirations because of the inconvenience of travel

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 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.