Seroma 7 weeks post TT. Last drain removed at 6 weeks. What am I doing wrong?

Question

I had extended TT 7 weeks ago. Originally has 2 drain tubes. The 1st removed week 2. 2nd drain tube removed at 6 weeks. Today is 7 weeks post op and developed Seroma. PS removed 350cc today. He said he knows there is more. Scheduled in 3 days to go back for more aspiration. He said fluid looks good. I can already feel the fluid draininack into abdomen. I am mot active and started wearing compression again. Is there something I am doing wrong? Is 350 cc considered significant?

Gary Lawton, MD, FACS · Answer

Depending on your size, and the time between drainages, 350 cc may not be significant.  If this fails over a period of 6 weeks or so then some other approach will be in order.

Hampton A. Howell, MD · Answer

Hi.  Typically, by this far out seromas have settled down, but they certainly can happen.  Various factors may come in to play but sometimes it basically just happens and needs to be dealt with.  It sounds like your surgeon is doing the right thing by draining these.  If they continue to persist, you and your surgeon may consider placing a drain back into the pocket of fluid, but that decision is best made by your surgeon.  Compression is typically helpful and in general I would expect that you would likely want to wear that pretty much all the time except for showering and similar things.  Keep in close contact with your surgeon.  Good luck and take care,Dr. Howell

Matthew A. Galumbeck, MD · Answer

Thank you for your question. Seroma (fluid collection) is one of the most common complications of a tummy tuck. It is unlikely that you are doing anything wrong that has led to this situation. With the drains removed, the fluid cannot drain out and accumulates in the abdomen. Many times the drainage tubes clog and are no longer functional, so it is best to remove them. Usually, an infected seroma is rare and other than causing discomfort, seromas don't cause long term problems. In my experience, serial aspiration (draining the fluid with a needle and syringe once or twice a week) usually will take care of the problem. In rare circumstances, a drain may need to be replaced, but usually after multiple aspirations have failed.Most of the time, each aspiration results in less fluid being removed, so with time the bulge from the fluid will get smaller.I believe that your doctor is doing the right thing by aspirating the fluid. Good luck and I hope your aspirations end soon.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

Seromas are very common after tummy tuck. The larger the tummy tuck volume, the larger the potential for seroma. 350 is a reasonable amount but nothing to worry about on its own. The key question is whether the volumes drained decrease over time. If there is still a seroma that drains 100s of mls in three months then there may be an indication for repeat surgery just to remove the seroma but so far so good. Hope that helps. Adam Goodwin

Stephen E. Zucker, MD (retired) · Answer

If your fluid collection does not resolve after one
     or two aspirations, ask your plastic surgeon to consider a referral to a
     hospital with interventional radiology services. They can carry out an
     ultrasound-assisted percutaneous drain placement until the fluid
     collection is resolved.  If
     necessary you can be considered for treatment to obliterate the fluid
     cavity.

Seroma 7 weeks post TT. Last drain removed at 6 weeks. What am I doing wrong?

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