Tummy Tuck Seroma? Fluid Won't Drain.

It’s not
unusual for patients to develop seromas following abdominoplasty.The problem may occur for a variety of
reasons in the post-operative period.In
some cases, the drains may have been removed prematurely, while in other cases,
patient activity levels are just too high.Regardless of the cause, clinically significant seromas should be
treated as soon as possible to avoid additional complications.Failure to address this problem can result in
the formation of chronic seromas, infection, drainage, wound break down and a
less than optimal result.When this situation arises,
treatment usually consists of serial aspirations and the use of compression garments.At this point the abdomen is still numb and
can be easily aspirated.This usually addresses
the problem, but occasionally more aggressive treatment is necessary.In cases where aspiration has been
unsuccessful, drainage with ultrasonic guidance may be appropriate.Under these circumstances it may be
appropriate to leave a drain in place. In other cases failed aspiration may indicate
that the seroma isn’t clinically significant. It’s safe to say that the vast
majority of seromas are successfully treated with conservative management.For this reason, it’s important to maintain
close contact with your plastic surgeon.

If your surgeon tried to drain your seroma with a syringe and it didn’t decrease in size, then you can either try again or you may require surgery to remove it.

What needs to happen immediately (so this seroma cavity does not become permanent) is another attempt at aspiration. After over two decades of doing tummy tucks, I have had my fair share of seromas (and even a few after drains have been removed), but I have only failed to successfully aspirate 1 or 2 patients with extremely small seromas, or extremely thick subcutaneous fatty layers. Seromas large enough to have a visible fluid wave are able to be aspirated in virtually all patients, though in patients who have a very thick fat layer that a "normal" length needle would not reach through, I use a longer IV needle, or even spinal needle.

Surgical placement of a new drain (under local anesthesia) is pretty easy if needed, though the cost of doing this in the hospital or outpatient surgical center may be prohibitive if your surgeon does not have his own surgical facility.

"Letting this go" and not draining the seroma may cause you to develop a pseudobursa that requires general anesthesia to surgically remove. To prevent the need for this, see your surgeon again, promptly!

Yes, it sounds like you have a persistent seroma or fluid collection under your skin.  In most cases, the fluid can be drained by your plastic surgeon in the office by numbing the skin and then draining the fluid with a needle.  However, sometimes it requires a radiologist to drain the fluid.  In this procedure, the radiologist uses an ultrasound to look through the skin and see where the fluid collection is located.  The radiologist can then place a drain directly into the fluid collection.  It sounds like this is what you need to have done.

 

Good Luck.

it is common to experience a seroma after a tummy tuck. often if your plastic surgeon can't aspriate from one area he can try aspirating from another area. also it is very important to keep your activity level to a minimum and wear a tight binder to keep pressure over this area.

best wishes,

sean younai, MD