5 Months Post Tummy Tuck: Been Draining Seroma for 4 Months Now

If you have been draining a seroma for the last 4 months then you may actually require a surgical revision.  This is because you may have "encased" the fluid with a protective wall that is preventing your body from absorbing the fluid.  This protective wall may need to be removed.

Follow up with your physician and follow his/her recommendations.  You definitely need to make sure that they are aware of your concerns.

KKNurse,  It is hard to know how much swelling you have without a photo. Swelling may persist in some cases for many months but should be getting better and not worse. Have you seen your surgeon recently? If not you should see them sooner rather than later. Good luck.

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

After a few months a seroma creates a life of its own and forms a bursa or capsule.  If this occurs there is no choice but to excised the bursa and replace the drain.  

Thank you for the question.

Although some swelling may be expected  four months after surgery it may be that you are experiencing  a chronic seroma.

If this is the case only good treatment option is to surgically drain the seroma,  excise the scar tissue around the seroma,  suture the abdominal wall flap back to the abdominal wall fascia (to promote adherence of the flap to the underlying fascia)  and use several drains.

 

I hope this helps.

you definitly should have exams over time with your surgeon to make sure the seroma has not reaccumulated. having said that you are 4 months "behind" on that side and the swelling may just be the result of repeated drainage or instrumentation.  if there is no seroma the lymphatic disruption will get better with time genrally. good luck.

A persistent draining Seroma is an unusual complication. If this has continued this long the area may need to be surgically explored and the Seroma cavity removed

If you had a seroma that persisted for four months, I would expect you to have more swelling than normal, and for it to last longer.  Be sure to see your surgeon to check that there is definitely not any continued fluid accumulation.  As long as there isn't, you should expect it to take longer than usual for the swelling to subside.

You need to have it checked out by your surgeon. The seroma cavity has most likely "walled off" and this warrants surgical revision. 

Unfortunately persistent or undiagnosed seromas will ultimately result in the development of a seroma cavity. This is a thickening of the tissues that is best compared with a rind on an orange. It causes persistent swelling in the lower portion of the abdomen which naturally defeats the whole purpose of the tummy tuck in the first place. At this point in time it is doubtful that this will resolve and your surgeon should re-operate to excise the cavity which should give you a nice flattening of the lower abdomen.