Persistent Seroma 14 months after tummy tuck and muscle repair. What can I do? (Photo)

Question

I had a standard hip to hip tummy tuck nd muscle repair 14 mth ago - I formed a seroma under my right breast and had it drained by the surgeon 4 times over 9 months - the fluid was always very dark red and the surgeon mentioned it should be a cloudy yellow. I have since had it drained under ultrasound and injected with steroids - two times standard red fluid around 50ml but the last time they found too many chambers and couldnt get the fluid all together - surgeon now wants to wait 1-2 years?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do with a persistent seroma many months after a tummy tuck. Thank you for your history. Let's review the definition of a seroma and a hematoma. A seroma is a collection of serous fluid. Serous fluid is your body's natural superglue that helps stitch edges together. This is usually clear yellow fluid. A hematoma is a collection of blood. Initially, the blood is usually bright red; as the oxygen leaves the blood, it becomes dark or purple. Your description of dark red material aspiration indicates that this is a hematoma at the time of aspiration. Sometimes, seromas turn into hematomas, and sometimes hematomas can turn into seromas. I agree with your plastic surgeon's course of action: he drained it until nothing could be drained, and steroids were also injected. At this point, there are two options. I would suggest conservative operations. Another option would be, if you genuinely want the mass to be removed, to make an incision over the mass and remove the scar tissue surrounding this resolved hematoma or seroma. I hope this helps answer your question about persistent seroma many months after a tummy tuck. 
If you have any more questions regarding reconstructive surgery after massive weight loss, please contact my office. Reconstructive surgeries after massive weight loss include an abdominoplasty, tummy tuck, thigh lift, breast lift, mastopexy, arm lift, brachioplasty, torsoplasty, back lift, buttock augmentation, and buttock lift.  Since these reconstructive surgeries after massive weight loss,   are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing these types of lifts. Do your research.  Make sure they have performed at least 100 of each procedure you are considering for reconstructive surgery after massive weight loss.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.

George Bitar, MD · Answer

At this point, there is likely a bursa or sac around the seroma.  Repeated aspirations will not resolve the fluid.  You could try drain placement with or without scarring agents to try to get the sac to collapse and seal.  More likely, you need surgery to remove the sac around the seroma with drain placement, so everything can seal back down.

Camille Cash, MD · Answer

I'm sorry to hear of the persistent seroma issues you are experiencing.  Typically if multiple aspirations of a seroma along with compression are not able to resolve it, a drain is placed.  If a drain is not successful in eradicating it then surgical intervention is sometimes necessary.

Daniel Barrett, MD · Answer

Dear Exuberant621881,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

I’ve answered this question many times. You need to have a penrose drain ( not any other type) placed in the pocket to establish drainage to the outside. Then the space will close up on its own. The drain will require a small scar and need to stay in for about one week

Persistent Seroma 14 months after tummy tuck and muscle repair. What can I do? (Photo)

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Persistent Seroma 14 months after tummy tuck and muscle repair. What can I do? (Photo)

Answers (9)

Answer: Seroma

Answer: Seroma

Answer: Seroma after tummy tuck

Answer: Seroma after tummy tuck

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.