3 Months Post Tummy Tuck After 250lb Weight Loss: Incision Lines Now Leaking

Question

At Week 3 Developed a Seroma, Had Jp Drain in Till Aout 2nd Month, with Lg Output 1000cc & up/24hrs. Never aspirated, but drain out about 3-4 weeks, and now my lower abd has a football sized protruding area, numb& red. Lower incision lines have started to leak fluid. Ps does not seem to be alarmed... I'm worried about sepsis, any ideas

Richard H. Fryer, MD · Answer

You most likely have a seroma after your tummy tuck procedure.  This is especially common after larger tummy tucks after massive weight loss.

	Persistent seromas (fluid collections) this long after a tummy tuck will most often require surgery to help them resolve.

Erez Sternberg, MD · Answer

This does sound like a persistant, non-resolving seroma (fluid collection under the abdominal skin) that needs to be addressed.  You can have a non-infected seroma which would require the placement of a drain in the office or even a trip back to the operating room to stitch the cavity closed and leave a better drain at that time.    

	    Seromas can also become infected secondarily and cause big problems.  Make sure you convey your concerns to your plastic surgeon so that he or she can tell you what they plan to do.  If you don't feel reassured, get the opinion of another surgeon. Good Luck.

Pablo Prichard, MD · Answer

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

Jeffrey Zwiren, MD · Answer

It is most likely that you have a recurrence of your seroma.   Unfortunately these seromas are not uncommon in massive weight loss patient.  You will more than likely need to have another drain placed until this has resolved.

David L. Abramson, MD · Answer

It sounds as if you have a persistent seroma. this will likely no resolve without drainage and may require a return to the operating room to eliminate the seroma cavity.

3 Months Post Tummy Tuck After 250lb Weight Loss: Incision Lines Now Leaking

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3 Months Post Tummy Tuck After 250lb Weight Loss: Incision Lines Now Leaking

Answers (7)

Answer: Recurrent seroma problem after an abdominoplasty

Answer: Recurrent seroma problem after an abdominoplasty

Answer: Tummy tuck

Answer: Tummy tuck

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Everything you need to know about Tummy Tuck

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