Recurring seroma after tummy tuck and catastrophic dehiscence

In these scenarios, the critical component of treatment is drain placement. You have that now and if it's time to start sclerosing the pocket of fluid that's ok. If that is not solving the problem, re-excision of the seroma pocket may be needed. I'm not sure if there was any deviation from the standard of care but at least you know the overall treatment plan for now. Best Wishes!!

Thank you for your question regarding the recurring seroma and dehiscence following your tummy tuck. Recurring seromas and wound dehiscence (where the incision reopens) are challenging but not uncommon complications. Here are some insights and considerations based on cases like yours:

Recurring Seromas: Persistent seromas can sometimes develop a thick, fibrous wall around the fluid collection, which makes them harder to treat. Repeated aspirations, while helpful short-term, may contribute to tissue irritation and prolonged seroma formation.

Possible Causes of Recurrence: Factors like the surgical technique, your activity level, and any previous history of seromas can contribute to persistence. If scans are inconclusive, it’s possible that residual fluid pockets or scar tissue are still present.

Treatment Options:

IR-Inserted Drain: An interventional radiology (IR)-inserted drain can allow for continuous drainage, which may reduce the need for frequent aspirations and allow the cavity to collapse over time.
Sclerotherapy: Introducing a sclerosing agent (like doxycycline) through the drain may help scar down the seroma pocket and prevent further fluid buildup. This is a more aggressive approach but can be very effective.
Surgical Revision: In persistent cases, surgery to remove the seroma capsule or address any unhealed tissue may be necessary.
Potential Long-Term Risks: Untreated or recurrent seromas can lead to infection, excessive scar formation, or even chronic swelling in the area. If left unresolved, it may also impair the quality of your final result and increase discomfort.

Lack of Urgency in Treatment: While your situation is complex, it’s reasonable to expect that your surgeon would pursue more aggressive treatment options, especially since this is now the third recurrence. If you feel your concerns are not being adequately addressed, consider seeking a second opinion from a plastic surgeon with experience in managing complex seromas and wound complications.

Thank you for sharing your journey, and I hope these insights are helpful as you discuss your treatment options with your medical team.

Sincerely,
Dr. Katzen

I am so very sorry that you are experiencing this. Yes, this does happen to others and surgeons who have practiced for a while do see this problem. Sometimes a cavity of scar tissue forms where the seroma is and must be removed to prevent the seroma reoccurring. I am surprised that the ultrasound and CT scan do not show this. Dye could be added and rescanned and the cavity would then show.