Drain Removed, Now Collecting Fluid. Normal?

Based on the pictures you have shown us it seems like you have a very nice result from your tummy tuck.  The fluid colection (seroma) does sometimes occur and takes a while to resolve.  If the fluid collection is excessive, it can be drained with a needle (but requires several visits and several aspirations) or a new drain can be placed.  If the collection is not large and is not bothering you, it can be allowed to resolve on its own.

Sincerely,

Martin Jugenburg, MD

Keep your compression garment on to help minimize your core motion and call your surgeon to have fluid aspirated.

This is a common problem with tummy tucks. No problem. The doctor wil need to tap the fluid on a weekly bases until it dries up.  No issue as long as it is handled correctly.

It is normal to have a
little bit of drainage after the drain has removed.  The skin wound will need a few days to fully
close and until that happens some fluid can leak.  However, there should not be a large amount
of drainage, nor bright red blood.   If
this happens, go see your surgeon immediately.

Often, fluid accumulation tends to go away on its own. However, if you find that it becomes particularly numb, swollen or painful, you should notify your surgeon right away to have the fluid removed.The tightness you're feeling is a normal part of recovery. You'll need to wait for the tissues to relax. This can take a couple of weeks.

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. I have never seen an infection from sterile aspiration of fluid.Best wishes,Pablo Prichard, MD

Thank you for the question and pictures.

Unfortunately, what you are experiencing is not unusual after tummy tuck surgery. The fluid accumulation is likely a seroma,  which is a benign collection of fluid in the space that was dissected during the tummy tuck surgery. Multiple episodes of aspiration may be necessary before it resolves. It should not detract from your final results.

Continue to follow-up with your plastic surgeon.

Best wishes.

Fluid accululation after a tummy tuck is not uncommon. However, with the drain having been already removed, the most reasonable way to remove this fluid, at least initially, would be to aspirate it out - using a needle. Often this has to be repeated several times before the problem (seroma) permanently resolves. If left untreated, this can become a chronic problem and deformity ultimately even requiring surgery to address it definitively.

Regarding being able to stand up straight by 3 weeks - you should be able to. I would discuss this issue and the seroma one with your surgeon immediately.

The fluid collection after your tummy tuck is called a seroma and whether to drain the fluid or wait out the resolution will depend on the size and how uncomfortable it is. We prefer to aspirate a collection as soon as we detect one as the tummy is numb, and patients feel better and do better after.
Best of luck,
peterejohnsonmd

Sorry to hear about your problem.  Most surgeons in North America use drainage tubes after a tummy tuck to remove fluid that tends to accumulate under the tummy skin flap.  A good way of avoiding drains, and avoiding the hassle of "seromas" (the fluid even has its own name!) is to see a surgeon who is trained to close the wound on the inside.  Yes, it takes time to do this, and it may cost  you a bit more, but you won't have to put up with the swelling, discomfort, and hassle of drainage tubes.  As an added bonus, graduated tension sutures (as they are called) also take all the strain off the wound closure, so you typically end up with better incision scars.  The medical term for this procedure is 'closing the dead space', and it involves quilting sutures that stitch the 'flap' (the skin and fat that the surgeon lifts off the muscle layer) back down.  Thus, there is no place where fluid can collect.  Healing is usually faster, since there is no movement between the layers that we want to heal together.  Many surgeons hate this added step, since it slows them down a bit in the OR and thus increases costs in the facility.  I have been using this technique for over 11 years, since it was taught to my by my colleague Ricardo Baroudi from Brazil.  I have not had any seromas at all in hundreds of abdominoplasties since using this technique, and I encourage my colleagues to adapt it.  For me, it is a no brainer-- the outcomes are much better for my patients.  

 FYI- If a seroma has been present for a long time, they sometimes will gain a tissue lining, which makes them resistant to treatment with repeated drainage alone.  Sometimes, it will be necessary to actually 'go back in' to strip this lining away so that the layers can stick together.  Some surgeons have used chemicals or drugs to stimulate the fluid pocket to scar together if repeated drainage does not work.  This usually involves temporarily putting some indwelling drains back in to place for a period of time.