How Much Fluid Can Seroma Hold?

I have drained more than 500 cc from a seroma but that is not relevant. Even if you put out 200cc per day that does not mean that you will collect 600 cc in 3 days. A seroma can put out more than the cavity from which it arises. In some cases the drain can be responsible for the persistent drainage. In many instances, the drain serves the purpose of allowing the cavity to shrink so that when the drains are removed, the cavity collapses. The seroma may close off or it may require repeated aspirations or replacement of the drain. In rare instances it forms a cyst which must be excised or sutured shut.

The size of the seroma is really not that important. The fact that it is being drained is important.  Removal of the serous  fluid is necessary to allow for the skin flap to re-adhere to the underlying muscle/fascia. Otherwise you may develop a chronic seroma cavity that would require excision of scar tissue (further surgery) to treat.  If your current drains  become nonfunctional additional drains may need to be placed.

Best wishes.

Patients who undergo tummy tuck should be aware of the recovery process and the possible risk of complications. One possible complication is a collection of fluid underneath the skin called a seroma. A small seroma may go away on its own but a large collection may require drainage or a small surgical procedure to evacuate completely. The most important aspect in taking care of these collections is addressing them right away. This will prevent them from becoming larger or interfering with your result. If you have a seroma, you should return to your plastic surgeon and let him know of your concerns and of the fluid collection. They will let you know the best way to address it and if a simple drainage or a small surgical procedure will be necessary. Patients who have a seroma should also use a tight compression garment as this will help collapse the tissue and make sure it does not return.

It appears that this is a chronic problem based on the condition of the drain.   Unless there is a sharp trend down in your drain output, you should have an informed discussion with your plastic surgeon on re-operation to excise the seroma cavity.   This is a known complication of tummy tuck surgery and an unfortunate outcome.   It sounds as though another procedure will be necessary to get you on the road to recovery.   I wish you all the best.

Paul S. Gill, M.D.

Gill Plastic Surgery

Houston Double Board Certified Plastic Surgeon

200 c's of fluid a day coming out of your drains is a lot of fluid. A seroma can become quite large and it could be several hundred cc's.

Thanks for the question and sorry to hear you are having problems.

In response to your question, the output of the seroma is dependent on several factors, including how large of a dissection plane was made in our particular case. Typically, seroma outputs will decrease over time. However, they can fall into a chronic category as my colleague mentioned, forming a pseudo-bursa, which would require intervention. I strongly suggest following up with your plastic surgeon and discussing the course of your treatment should the seroma fail to resolve with conservative measures.

Warmest Regards,

Glenn Vallecillos, MD, FACS

Regarding: "How Much Fluid Can Seroma Hold?
Is there a point to where the pocket of tissue just can't hold anymore and it stops filling? I have drains in still, but the tubing is starting to show some tear and might give out soon. I'm still outputing about 200cc a day. If it breaks, in 3 days will I have 600cc of fluid in my tummy? What will happen? What's the biggest seroma you've dealt with?"

I am sorry to hear of your condition. 

If you are putting 200 cc a day and you are now weeks after surgery (as implied by the frayed condition of your ?single drain), you and your surgeon need to huddle and discuss alternative treatments.  The amount of fluid output depends on the operation, the extent of the undermining during the operation and disruption of lymphatic channels and even your former size (people who lost a lot of weight retain large vessels and lymphatics despite regaining smaller sizes). Finally, patients with history of radiation of the lower tummy will drain for prolonged periods of time.

In your case, it SOUNDS like you may have a CHRONIC seroma. In this case, the walls are smooth and are NOT apt to stick to each other. In such cases, one of the options is to re-operate, remove the smooth scar lining and close again with mild compression to promote adherence and obliteration of the seroma.

Time to discuss this with your Plastic surgeon.

Dr. Peter Aldea