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Seroma After Tummy Tuck and Extensive Liposuction, Is Surgery The Only Solution?

I had a full tummy tuck as well as liposuction on 75 percent of my back August 26th of this year.. I live in the us and had it done abroad.. Four days after surgery my ps pulled the drain.. When I returned home I developed a seroma that covered my entire abdominal wall..Intervention radiology placed a drain a week ago.. I followed up with my PCP today and he is concerned that I'm still draining at least 100ml everyday he feels the only solution is surgery.. Is this true.. is surgery..

Doctor Answers (3)

Post abdominoplasty results

+1

Mrs. McMillan: I agree with the previous surgeons. Yes, the drains were likely removed too soon and yes, it isn't good to have 100 ccs per day draining two months out. Your options are several. It can be aspirated 2-3 times per week and may subside in a month or so. On rare occasion, one may have the fluid collecting space (pseudo bursa) sclerosed with an chemical agent ( maybe an antibiotic) in an attempt to destroy the slick surfaces that secrete. Results are mixed at best. However, most of the time, if it doesn't resolve "soon", you may likely have the pseudo bursa removed surgery.....and drains left in place at the time.


Phoenix Plastic Surgeon
5.0 out of 5 stars 6 reviews

Seromas

+1

Seromas can be frustrating.  They are more common when extensive liposuction is combined with a tummy tuck.  Generally, in my practice, I leave the drains in until they aren't draining more than 25-30 cc in one day.  Sounds like your primary surgeon may have removed it a bit early.  So, in your case, definitely leave the new drain in!

Sometimes, more than one drain may be required, if all areas aren't being fully drained by the one you have.  Alternatively, percutaneous aspiration of small secondary fluid collections can also be done by your PS.

Some patients may need to keep their drains in for several weeks!  Be patient - these things usually settle down.

Additionally, wear compression garments.  Also, have the drainage fluid checked to make sure there isn't a low-grade infection that could increase drainage amounts.  Don't be overly active - more activity seems to create more fluid.

Don't be in a rush for re-do surgery at this point, unless you have a "pseudobursa" as demonstrated by ultrasound.
 

All the best!

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 33 reviews

Seroma After Tummy Tuck and Liposuction Abroad. Surgery only Solution?

+1

Unfortunately, your situation illustrates many of the unspoken problems with having surgery in distant locations and then returning to US with complications. It happens far more often than the foreign surgeons would have you believe, and not only are the results often disastrous, but any initial cost savings are erased many times over by the costs of treatment of the complications.

Although you are still having a fair amount of drain output, you may still get lucky and get away with just having the drain in for a long time. Are you wearing a compression garment? Limiting your activity? Is the drain functioning optimally or should another be added? This is not the type of the thing that can be managed well by a PCP. You really need an experienced plastic surgeon to be following you and helping decide if in fact surgery is the optimal solution. On the other hand, you might find it difficult to find a plastic surgeon who is willing to take on the hard work and potential liability risks of treating a complicated problem resulting from surgery performed in some distant land. 

Having a combination of a full tummy tuck and liposuction of 75% of your back is a lot of surgery, and it would be unusual for your drain to be able to be removed in only four days. For large procedures with extensive undermining, drains can sometimes be in for as long as a month, although the longer they are in, the greater the risk of infection, and you are already at the one month mark. However, surgery at this point has many risks, is not always successful, and should not be lightly undertaken unless absolutely necessary. 

Braden Stridde, MD
Federal Way Plastic Surgeon
5.0 out of 5 stars 28 reviews

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