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Is It Normal to Get a Seroma 2 1/2 Weeks Post Op Tummy Tuck and Liposuction?

I had a tummy tuck/lipo on Oct 1. Drain was out 11 days postop when there was still drainage of about 30-40/day. Last Thursday, my pubic area was hurting and incision was swollen above. There was a wavelike motion when i would touch the stomach. I called the PS and he put in a seroma cath on Friday. Within 6 minutes, there was yellow-clear drainage of 200 ml. Within the rest of the day another 100. it has consistently been about 75-100 a day.normal? Why is there so much drainage now? advice please.

Doctor Answers (6)

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. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.
Best wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
5.0 out of 5 stars 27 reviews

Seroma After Tummy Tuck

+1

Yes what you are experiencing can happen even 2 weeks after surgery. Repeated aspirations are usually necessary and sufficient to treat the seroma. Continue as you're doing with close follow-up with your plastic surgeon. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 726 reviews

Seromas

+1

Seromas can happen with any procedure that leaves a "dead space."  It may take a few days to a week for it to get better.

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

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Seromas

+1

Sounds like your surgeon is doing the right things.  Either repeated aspiration or placement of a seroma-cath is the correct treatment.  A higher level of production of fluid can occur with over-activity, lack of external compression, or sometimes, infection.

It should taper off with time...but they sure can be frustrating for everybody.

 

Best wishes,

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 28 reviews

Preventing a recurrent seroma (fluid collection) after tummy tuck

+1

In my experience, this can be caused by increased activity or aggravated by certain types of garment which are tight around the waist and act like a tourniquet on the lower abdomen. With the seromacath in place, do not exercise and wear a garment that provides uniform compression over your entire abdomen i.e, spanx or body suit that covers your entire torso

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Seroma and Tummy Tuck

+1
Patient are different from one to another therefore some patient produce more fluid than others. This area is rich in lymphatics which produces the fluid. Equally important if there is a large amount of fat in the area there tends to be more fluid produced. I usually recommend removal of the drains when the production is less than 25 ml/day. Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 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.