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

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.
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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.

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.