Fluid and Blood Clot Discharge After Tummy Tuck

Question

It's almost 5 weeks since my Tummy Tuck. 2 weeks ago, fluid started leaking from my incision (a red watery fluid), which my plastic surgeon told me it was seroma and that it needs to come out, it's not harmful, and that I just need to wear my binder tighter. Another 2 weeks have passed and the fluid is still coming out more than before. Now I have a small hole (smaller than a dime) under my belly button and yesterday, a clot came out. Is it normal? Or is there anything that must be done? Please advise. I will say besides this hole, the entire incision is healed.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding the ongoing fluid and clot discharge nearly five weeks after your tummy tuck. I appreciate the details you’ve shared — and based on what you’re describing, this situation needs follow-up care from your plastic surgeon right away.

At this stage in your recovery, it is not normal to still have active drainage or a small open wound, even if the rest of your incision has healed well. The red, watery fluid that has been leaking from your incision for two weeks likely indicates a persistent seroma — a collection of fluid under the skin — which can sometimes open spontaneously through the incision line or at a weak point in the tissue.

The fact that you now have a small hole under the belly button and passed a clot-like material could mean one of two things:

A piece of old fibrinous tissue or organized clot was expelled from the pocket of fluid — which can happen in chronic seromas.

You may have developed a small wound dehiscence, or reopening of the incision internally, which allowed the clot and fluid to drain.

While your surgeon is correct that seromas need to drain and are not inherently dangerous, persistent drainage, especially increasing in volume or mixed with clotted blood, needs medical attention. Simply tightening the binder may no longer be enough, and continued leakage can delay healing, increase scar risk, or even become infected if bacteria enter the open area.

Here’s what should happen next:

Contact your plastic surgeon immediately and ask to be seen in person.

You may need in-office drainage, debridement of the wound, or even a temporary drain placed to help the area heal correctly.

Keep the area clean, avoid applying anything without medical guidance, and wear your binder as instructed until reassessed.

Fortunately, most small wound openings or chronic seromas can be easily managed if addressed promptly — but leaving them untreated can lead to complications.

Wishing you a quick resolution and full healing ahead.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS
(Certified by the American Board of Plastic Surgery and President of the American Society of Bariatric Plastic Surgeons; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery; Member of the American Society of Plastic Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame)

Please don’t delay — open wounds and persistent drainage after surgery are always worth a professional in-person evaluation. Proper management now will protect your long-term results.

Otto Joseph Placik, MD · Answer

It is difficult to assess from a message if this is a big or a small clot.
Most likely it sounds as if it was a relatively small clot and is probably of no significance.
It sounds as if things are under control. Occasionally a permanent suture may act as a source of persistent drainage and may need to be removed in order for the drainage to cease.
Alternatively, if a mesh placement or hernia repair was perfromed, this may require other treamtents.

Farbod Esmailian, MD · Answer

This is not normal, bu sounds like you had a seroma like your surgeon said.  If there is no fluid draining it could be that the seroma is dried up.  The one thing I would like to know is if there hole is begining to close.  If not, there may be a permanent suture underneath the area that could be irritating and preventing the hole to not close.

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