There has been no liposuction, and its been getting drained, twice a week, staying still and keeping it bound.Yes, for 3 months I've been a good sport.=o) We even put another drain in, seemed to work for awhile, but came back. It's not as big as before, maybe 4x4inches. I paid $12,000 which I know is on the high end, and now I'm being charged another $2000 to hopefully take care of the problem. Should I give it more time, keep draining it or surgery?
I Had a Tummy Tuck October 3 and Still Have a Seroma. Do I Need Surgery to Remove Capsule?
Doctor Answers (6)
Seroma After Abdominoplasty
I know 3 months seems forever when you are going through this. In 30 years I have seen 3-4 patients with a seroma requiring drainage for up to 4 months. Sclerosing agents rarely work on organized seromas although it never hurts to try. You may need surgery to remove the scar sac making the seroma and I would hope your surgeon would fix this at no cost. I find doing this for patients pays off many fold in future referrals and perhaps your surgeon can be convinced of this. We now use tension advancement sutures and seromas are no longer a problem so if you do have more surgery ask your doctor to use that technique.
Excision of a seroma pocket
Your plastic surgeon is in the best position to help decide what the problem is and how to correct it. If the fluid keeps collecting then a drainage tube may have to be re-inserted. It the pocket is still there you may need to have the seroma capsule excised. If you are draining less then 25 cc each time then it is likely that this will resolve on its own. Once it is totally gone it will not come back.
As stated by others, at this point either a sclerosing agent or reoperation are the best two options. Repeated aspirations will not be effective if the seroma is not decreasing in size between the aspirations.
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Seroma after tummy tuck.
This is a definite challenge. A seroma that develops and persists can certainly form a mature lining (or capsule). I would try a sclerosing agent another trial at a drain. Removal of the capsule can always be a long term solution and I would also use a drain for a long time afterwards to make sure there is very little chance of another seroma forming. Good luck.
That's a tough problem. I think that unless your surgeon uses a sclerosing solution it is unlikely to go away for good.
Treatment of a Fourth Month old Tummy Tuck Seroma
No one can advise you better tan your surgeon who hopefully is still seeing you. He/she operated on you and should have the experience of managing your Seroma. Generally speaking, persistent aspirations, need to put in per cutaneous drains without resolution of the serma suggest a chronic Seroma. You may want to consider irritating the lining by injecting an irritating sclerosng agent into it and see if that resolves the problem. If not, you would do best by having a small re-operation with excision of the Seroma walls and closing over drains.
Peter A Aldea,MD