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Why Do I Have Seroma After Tummy Tuck?

I am 7 weeks post Tummy Tuck and still have fluid that builds up, though it seems to be decreasing weekly. At last drainage, it was under 10 cc's for a week. I had my surgical drains in for 5 weeks. I have done nothing strenuous and continue to wear my compression garment and have added an abdominal binder. I am starting to feel like this will never go away! I am in my thirties, in good shape and don't understand why this is happening. Could there be something wrong with me that is causing this?

Doctor Answers (4)

Seroma after tummy tuck

+2

Yes, it is "normal.  Be patient and it will probably resolve. It sounds like you have a good, attentive surgeon, so stick with him/her. Everybody is different and recovery varies, but you are certainly within the "normal" range. Good luck.


Frankfort Plastic Surgeon
5.0 out of 5 stars 11 reviews

No quick answer...

+2

The first thing you need to appreciate is you have a lot of company....studies show as many as 50% of patients have some fluid under their abdominal flap after a tummy tuck.

As for why you have persistant fluid it could be a number of factors - most of which we don't understand. If you were obese and had bariatric surgery, I often find large vessels when doing a belt lipectomy or tummy tuck. These vessels always need to be tied off and I'm sure they ooze more than patients who have never been heavy.

A small number of patients who have persistant fluid actually develop a "bursa" which needs to be surgically removed to keep fluid from accumulating. With only 10 cc a week it sounds like you don't have one and will be fine soon. Good luck.

Robert Frank, MD
Munster Plastic Surgeon
5.0 out of 5 stars 13 reviews

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.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 29 reviews

Million Dollar Question

+1

Seroma prevention is the holy grail of tummy tuck surgery and there is no universally accepted way to prevent them. Some surgeons advocate tacking down the skin flap to the muscle wall; others recommend creating a "body cast" to prevent fluid buildup; still others have tried injecting a "glue" so that the skin flap will stick to the muscle.

Treating an established collection, or "seroma" has its own set of different approaches.

In summary, seromas are extremely common and it sounds as if you are doing everything right and there is nothing "wrong with you." It is encouraging that so little has been coming out of the drains so hopefully the process will resolve soon.

Good Luck!

Jeffrey Horowitz, MD
Bel Air Plastic Surgeon
5.0 out of 5 stars 12 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.