It sounds like your doctor did the right thing by removing the seroma cavity. Be patient, and follow your doctor's advice.
Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. It sounds like your surgeon is treating you appropriately. Sometimes seromas can occur despite the best treatment.
Pablo Prichard, MD
Sounds like your doctor is managing seroma correctly
Your doctor is managing the seroma correctly. Hopefully, in time, the drainage will continue to decrease until it is small enough to remove the drains.
Occaisionally, after very prolonged periods of drainage, a membrane can form around the seroma and prevent closure of the pocket. I am sure your doctor was looking for this and addressed the problem during the re-surgery.
It sounds to me like you are being managed properly, so it is important to follow your doctors plan.
Persistent and recurrent seroma after tummy tuck
This is quite unusual but it sounds as if your surgeon is delivering appropriate care and management of your condition. In some instances "sclerosants" or quititing sutures may be required to obliterate the space.
Chronic seroma after he tummy tuck
Tummy tucks are a very popular and effective way to contour the abdomen. Like all surgery, tummy tucks to carry some risk. One unfortunate complication is the development of a seroma. As a seroma begins to develop, your plastic surgeon may choose to drain it with a needle and syringe. After this drainage, it is essential that you wear a tight compression garment to prevent the fluid from reaccumulating. If the seroma returns, it is possible that the inside of the seroma has created a wall tissue that is now producing that fluid. Your surgeon may open a small portion of the incision and place a small wick in this area to help the seroma close. Another option is to perform a small surgery to remove the wall of scar tissue that continues to produce this fluid.
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Your surgeon clearly understands the nature of seromas. He took you back to the OR because the seroma cavity will start to get a rind or start of a capsule with will impede the recovery.
It's often just a matter of time for the fluid to slow down. Remember it's that the body has to reestablish the tiny, one cell layer thick lymphatic vessels that return that fluid to the rest of the body. Time will heal.