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Bloody Seroma Caused by an Aspiration Mistake?

I am 5 weeks post-op from a tummy tuck. After week 2 I began to get a waterbed wave of fluid across my abs above my incision. The PS removed the fluid that was a pinkish/red color. During the aspiration, I felt the needle poke me inside, the PS apologized.

On my 2nd visit a week later, the fluid was a dark, deeper red and also on the 3rd visit. The fluid level is just about the same each time. The PS is now concerned about the color of the fluid.

Is it possible that he hit something when he did the 1st aspiration? He wants me to get blood work and possible surgery at my expense.

Doctor Answers (3)



Seromas are quite common after tummy tuck operations, and typically they are treated by serial aspiration. The red coloration at the first aspiration is a sign that blood was there from the first. The fact that it was redder just means there is a bit more blood and less serum. If more blood was introduced it was probably from passing the aspiration needle--- it is being passed through living tissue with blood flowing, so I don't see any "mistake." 

A surgical procedure seems unlikely unless all else fails, including repeated aspiration, insertion of a drain, and an attempt at sclerosis, which is injection of a caustic material such as betadine, tetracycline or alcohol which usually causes the secretion to stop.

Thanks for your question and best wishes. 

Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

It's possible but probably no cause for alarm


Seroma formation after abdominoplasy is very common. Almost always it can be sreolved by serial aspirations in the office. Sometimes this may require 5 to 10 sessions, but usually not. If the aspiration needle nicked the fascia, you might have bled a bit into the seroma, turning it burgundy. Actually only a few drops of blood can do that.

I would continue with the serial aspirations. I think your problem will resolve itself.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

Seroma and Fluid Accumulation after Tummy Tuck


Seroma and fluid accumulation is the most common issue after tummy tuck. Once the drains are out the only options are to do serial aspirations, place another drain or rarely surgery. During the aspirations there is always the risk of reaccumulation and the risk of have some bleeding from the tiny blood vessels in the area. That bleeding is usually self limited and not a reason to have surgery.

The reason to perform surgery is because after multiple aspirations and perhaps even drain placement the fluid continues to build up over and over. Again that is a rare instance, I for instance have never had to take a patient back to surgery for recurrent seroma.

As far as the cost, that is something you need to discuss with your plastic surgeon. Unfortunately there are some costs that are passed down to the patient as the procedures are not covered your health insurance.

Good luck

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 31 reviews

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