Will removing pseudobursa cause complications in healing? (photo)

Question

I had a full tummy tuck in 8-1-23. In September at follow up I had a seroma he cut open and drained about 2 cups of fluid. In December I saw my Dr. and had fat nercrosis removed in January. He said I had scar tissue left and we would discuss at it at my next appointment. On April 16th he is going to start injections to dissolve the scar tissue. The area is hard, uncomfortable and hurts. I want this removed but am afraid I’ll possibly go through all the above again if I have a revision.

J. Timothy Katzen, MD, FACS · Answer

Hello,
Thank you for reaching out with your concerns about undergoing pseudobursa revision after experiencing issues related to a seroma following a tummy tuck. Your situation is not uncommon, and it's important to address these complications effectively.
Understanding Pseudobursa: A pseudobursa is an encapsulated seroma that can form after fluid accumulates and isn't adequately reabsorbed by the body. This can create a chronic issue that often requires surgical intervention for resolution.
Revision Surgery: The decision to undergo pseudobursa revision is generally recommended if the pseudobursa is causing discomfort, aesthetic concerns, or functional limitations. The surgical removal of a pseudobursa involves excising the encapsulated seroma cavity, which can help flatten the area and alleviate associated symptoms.
Risks and Complications: Like any surgical procedure, pseudobursa revision carries potential risks. However, these are generally manageable, especially when performed by an experienced, board-certified plastic surgeon. Complications could include infection, bleeding, or recurrence of the seroma, but these risks are relatively low if the surgery is handled correctly.
Postoperative Care: Effective postoperative care is crucial. This will likely involve drains to prevent fluid accumulation and compression garments to support healing. Your surgeon will provide detailed instructions based on the specifics of your surgery.
Choosing a Surgeon: It is essential to choose a plastic surgeon who specializes in body contouring and revision surgeries. A surgeon with extensive experience in managing complications related to tummy tucks will be able to provide the safest and most effective treatment approach.
Moving Forward: Discuss all your concerns and the potential risks and benefits with your surgeon. They should be able to offer a detailed explanation of the revision procedure, what you can expect in terms of recovery, and how they will manage any potential risks.
Your proactive approach in seeking advice and considering revision surgery is commendable. Taking these steps can significantly improve your quality of life and satisfaction with your tummy tuck results.
I hope this response has provided you with a clearer understanding of what to expect from pseudobursa revision surgery and how it might help resolve your current issues. Wishing you the best of luck with your decision and the procedure if you choose to proceed.
Sincerely,
Dr. Katzen

Benson Pulikkottil, MD · Answer

I’m sorry this happened to you! Yes the pseudocapsule needs to be removed. I typically carefully remove this tissue and put in several sutures to close the space and prevent the tissue from rubbing causing fluid buildup. I also may place a small drain to help prevent this from happening. I would love to evaluate and hopefully take care of you at LaVie Plastic Surgery Institute.
BestDr. Benson Pulikkottil

Ronald J. Edelson, MD · Answer

If there is no further seroma it just takes time for the scar tissue to soften up. Scars can be injected with steroids but I would not try to inject anything other than that. Massage over time can help break up scar tissue

Connie Hiers, MD, FACS · Answer

Actually, the wall of the seroma, or bursa, should be removed to decrease your chance of reoccurrence. A drain will be needed as well.

Will removing pseudobursa cause complications in healing? (photo)

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Answer: Seroma

Answer: Seroma

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Will removing pseudobursa cause complications in healing? (photo)

Answers (4)

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