Ask a doctor

Seroma Correction After Tummy Tuck?

I had a seroma cavity correction after TT. When my doc has opened the scar, he has found a space, big bruise, appr. 20x25 cms. with scar tissue and liquid inside. He has made the excision of scar tissue, added internal sutures where needed and made insections to ensure the further skin adherence in those places. I wear compression again.I'm really depressed by the bruise size. That means that almost all operated skin didn't adhere to the underlying muscles. What shall I expect?new seroma or worse?

Doctor Answers (3)

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 a seroma keeps recurring after an extended period of time of aspiration, It may be advisable to re-open the area and remove the entire capsule, both front and back walls of the capsule, otherwise it will come back. Drains need to be used, possible tissue glue, internal sutures, use of an irritant to encourage the tissues to grow together.
Best wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

Seroma after tummy tuck

+1

Getting a small to moderate seroma after a tummy tuck is common. The large seroma that you describe is less so. Your plastic surgeon treated it as appropriate. Now you have to heal up a second time. Please be aware that second hand smoke can make the healing process slower.

 

Good luck and thank you for your question.

 

Sincerely,

 

Anire Okpaku MD

 

Tener desde un pequeño hasta moderado seroma (concentracion de liquido) despues de una abdominoplastia es comun.  Lo que usted describe como un gran seroma es pequeño en realidad. Su cirujano lo trato de manera apropiada. Ahora usted tiene que sanar por una segunda vez. Por favor acuerdese de que el cigarro puede prejudicar el proceso de sanamiento y hacerlo mas lento.


Suerte y gracias por la pregunta

 

Atentamente,

Anire Okpaku MD

 

Anire Okpaku, MD FACS
Miami Plastic Surgeon
4.5 out of 5 stars 25 reviews

Seroma Correction After Tummy Tuck

+1

Natalia:

You are correct in noting that the skin flap did not adhere to the underlying abdominal wall. The seroma interfered with that normal process of healing.

It sounds like your surgeon did what was appropriate here--removing the wall of the seroma cavity, and suturing the skin flap down to the abdominal wall. 

What you should expect is for your wound to heal, the bruise to resorb, and not to get a recurrent seroma or worse.

Thanks for the question, best wishes.

 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 32 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.