Postoperative fluid buildup after an abdominoplasty is fairly common. However, it is not common to persist after 4 months. You should consult with your surgeon to determine if a drain needs to be inserted and/or a surgical procedure should be considered to treat the chronic fluid collection.
You may be headed for more surgery
You need to be in close contact with your surgeon as this can ultimately require a surgery to removed the chronic seroma capsule. Other options include placement of a drain or sclerosing agents or very frequent aspiration.
Chronic seroma pocket can be treated
If you still have fluid aspirated from this area 4 months after your surgery, you are dealing with a chronic seroma pocket formation. This will require placement of a drain to drain the fluid and then place a sclerosing agent (an irritant) to cause internal scarring and obliteration of the fluid pocket. If this does not work, you will need a reoperation to peel out the serous pocket membrane and allow scarring with a drain in place.
You should see your treating surgeon. This could be a difficult problem and if not done the right way you can end up with skin irregularities in this area.
Fluid collections are either hematomas or seromas. Your surgeon should be following and treating you for this. This might require aspirations or a drain. However, what you might be describing is edema of the upper abdomen or epigastric region. Because the lymphatic drainage is normally against gravity toward the axilla, this region can experience difficult edema especially if liposuction has been perform. Compression garments may be helpful but your surgeon should help supervise their use as they could also make things worse if there are constriction areas. Massage and lymphatic drainage might be helpful. Occasionally permanent fullness remains. You'll need to be patient and diligent in your follow-up.
Ask the doctor who is treating you. Our opinions will not help you -- you need to have continuous care until the seroma goes away. There is no magic pill or potion.
You should see your surgeon to get this checked out because fluid at this time is not common. Sometimes it can go away on its own but if there's a lot, it needs to be drained by your surgeon. You should be wearing a compression garment to help with swelling, but only if advised by your surgeon. Make sure you're following a healthy lifestyle because this will help.
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.
Pablo Prichard, MD
Fluid build up after tummy tuck
It is common for fluid to build up after a tummy tuck however four months is a little long after the fact. I recommend you see your surgeon as soon as you can about this. Compression garments help ease the swelling and you may benefit from wearing one. However please follow your surgeon's advice. A drain or additional surgery may be required.
Possible seroma that hasn't been resolved
The majority of swelling usually resolves after the first few weeks, so at four months it shouldn’t be as prominent anymore. You should see your surgeon to determine the cause of the buildup and to determine the best course of action.
It is very rare to have a seroma at four months but if it is being regularly drained and not decreasing in amount, then the patient may need a drain placed or a surgical procedure to remove the seroma capsule.