Where Should my Compression Binder be Positioned?

Question

I had a TT/Lipo about 3 weeks ago. I developed a seroma which is drained every 3-4 days. I was wearing the garment around my love handles thinking it would prevent/reduce swelling. I am wondering if the garment actually forced fluid into my upper abdomen area, slowing skin/muscle reconnection. Should I center it over my navel or position the top of it just below my nipples?

Nikesh K. Patel, MD · Answer

Cover your whole belly with the binder, from your breast folds to below the incision.

	In general the binder is used after a tummy tuck to apply pressure and close off the open space that was created during surgery where fluid may accumulate.  It should be over the entire anterior abdominal area where the surgery was performed to help prevent/reduce seroma formation.  

	Usually seromas form in the lower abdominal area where the incision line is because that is where the widest area of dissection for surgery was performed and where gravity will trap most fluid that will form further up in the abdomen.  Because of this, the upper abdomen has a lower chance of forming a seroma than the lower area so it is vital that the lower area is covered by the binder, but still important that the upper area is also covered.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!.  The tummy tuck procedure is an 
excellent method for contouring of your abdomen, often removing the 
excess skin as well as tightening the abdominal wall.  After nearly all 
surgical procedures, a potential space is created from where the 
surgical procedure/dissection was performed.  This is especially true 
for the tummy tuck, in where the abdominal flap is raised off of the 
abdominal wall and then redraped atop the area to contour the abdomen.  
The procedure alone promotes swelling and inflammation, which typically 
lasts for 6-12 weeks.  This may even last longer if liposuction has been
 performed in addition.  During this time, a few things may be done to 
allow adherence of the abdominal skin/soft tissue to readhere to the 
abdominal wall and close that space.  Many surgeons use drains to 
evacuate the expected serous fluid from building up.  Stagnant fluid as 
such may be a nidus for infection as well as does not allow the tissue 
to adhere back to its normal anatomic position.  Drains usually are 
removed once output is <30cc/day - usually removed within 3-4 weeks 
on average, sometimes longer.  When this occurs, a seroma may develop - 
which may require aspiration or surgical evacuation to rid this in order
 to optimize your result.  This is not an uncommon reason for 
persistent swelling and/or bulging in a certain area of your belly.  Of 
course, thwarting the development of a pseudobursa, or seroma capsule, 
is always best, to provide the best result as well as avoid any future 
procedures for this.  This may be a troubling consequence and often 
compromises your overall result.  Thus avoiding this complication, in 
whatever manner, is the objective.  "Drainless" tummy tucks are becoming
 more popular - basically, the overlying tissue is physically sutured to
 the abdominal wall to close the potential space.  In addition, most 
surgeons typically restrict vigorous activity/strenuous exercise as well
 as lifting restrictions of usually <20#, especially the core, for 
6-8 weeks to allow healing to continue.  Most also often recommend an 
abdominal compression-type binder or garment, which will serve to 
provide 
compression as well as assist to decrease swelling and eliminate the 
dead-space of the area for at least 6 weeks as well. Your binder should be worn snug and low on the hips as well as give compression to areas that have the swelling.    After the initial 
binder, many patients like the Spanx garments.   Most patients are 
able to return to most activities within a couple of weeks, provided 
they adhere to the restrictions.  Overall, this is a procedure 
with a high satisfaction rate.  Discuss the procedure and postoperative 
instructions/restrictions with your surgeon, as these will vary among 
surgeons.  Hope that this helps!  Best wishes!

Jerome Edelstein, MD · Answer

The support garment should cover the incision – if you notice it has slid upwards, you can slide it back down by pulling down at the sides.I generally advise patients wear their garment 24 hours a day for three weeks, removing it only when bathing or washing it. From 3 to 6 weeks, wear your garment in the day only. It helps with easing swelling and reducing the risk of seroma.

Rodger Wade Pielet, MD (in memoriam) · Answer

The placement of the binder does help obliterate the dissected space, but it does not immobilize your trunk.  You must walk, breath, change position and seromas can form.  The best person to take direction from is the surgeon that did the dissection,  only this person knows what happened during the abdominoplasty.

Jeffrey E. Kyllo, MD (retired) · Answer

This question really needs to be directed to your surgeon.  Seromas are quite common after abdominoplasty and currently there is no way to insure that they don't occur.  If they do occur, the usual treatment is to aspirate, or stick a needle in every few days to drain it.  This may need to be done 1-6 times or possibly more.  I personally do not think the binder has much to do with seroma treatment or prevention for that matter.  I think the binder helps patients be more comfortable and secure feeling.  It may help to some degree in prevention of seromas.  You want to make sure that the lower edge of your binder stays below your incision line to help give even compression.  I would not raise it up to below your nipples.  This will potentially cause more swelling down near your incision and this is to be avoided.  I definitely would ask your surgeon what he/she would like you to do.  The seroma will go away.  That is the good news!

Where Should my Compression Binder be Positioned?

Answers (5)

Answer: Abdominal binder

Answer: Abdominal binder

Answer: Where should binder be positioned

Answer: Where should binder be positioned

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Where Should my Compression Binder be Positioned?

Answers (5)

Answer: Abdominal binder

Answer: Abdominal binder

Answer: Where should binder be positioned

Answer: Where should binder be positioned

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.