Normal swelling or seroma 18 days post-op?

TTMR 18 days ago. Incision healing well. 1st drain removed 9 dpo and 2nd drain removed 18 dpo. Output at time of 2nd drain removal was 25 ml per 24/hour period for several days. Wearing compression garment 24/7. Entire abdomen feels like a waterbed. Swollen and slightly puffy to touch. Possible to have entire area as seroma or is seroma usually more localized?

Doctor Answers 5

Seroma presents like a waterbed

It sounds like a seroma.  Seromas are not typically localized and present like you are describing.  See the plastic surgeon.  Sounds like you need a drainage.

San Antonio Plastic Surgeon
4.9 out of 5 stars 136 reviews

Possible seroma after tummy tuck

Many patients have this questions about 2-3 weeks after surgery. If you can feel fluid slosh from side to side when you are lying down then you likely have a seroma. If the skin of your abdomen just feels squishy or puffy it is likely just normal swelling after a tummy tuck. Your drain was in longer than I typically see with a tummy tuck and under 30cc/day is usually the time to pull the drain. Was the drain just pulled today? It is unlikely you would develop a seroma this quickly. See your surgeon if your symptoms worsen. It can wait over the weekend if a seroma does develop. 

Josh Olson, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 90 reviews

Concerned about seroma after drain removal

Hello, texasmae.  In light of recent drain removal and your description of "waterbed,"  you may have a seroma.  If you have a significant seroma, you may see and feel the fluid wave when you palpate on your abdomen.  Please see your plastic surgeon to be evaluated.  Keep your compression garment.  Good luck.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

Online Consultants cannot be Specific Enough…

Thank you for the question.
As always, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.
Generally speaking, abdominal wall "swelling" after tummy tuck may be related to:
1. Swelling in the soft tissues. This may take several months to resolve and may worsen with increased activity or at the end of the day. Patience is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle. this may consist of blood ( hematoma) or serum (seroma). This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound may be helpful). Treatment consists of aspiration; several episodes of aspiration may be necessary.
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication) of the rectus muscles. These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year (or greater) for complete skin redraping to occur.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Seroma After Tummy Tuck?

In all likelihood is is just generalized swelling, as your surgeon was conservative in taking your drains out, though there is a small possibility that you might have a seroma.  I suggest calling your surgeon to be seen to determine this, as it will affect your results if it is present and not treated.  It can be either localized or generalized, if it is present!

John Millard, MD
Denver Plastic Surgeon
4.3 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.