40 days post op, How Long Will a Seroma Last After Tummy Tuck and Liposuction?

Seroma is the most common complication to occur after tummy tuck surgery. It is not a serious complication and is usually prevented by the placement of drains during the surgical procedure.  The drains are removed when the drainage is less than 25cc for a 24hr period of time.  The small amount of serous fluid that accumulates after this will be absorbed by the body.

Even with the placement of drains a seroma may develop.  It is treated with serial aspiration just as your surgeon is doing.  The seroma usually goes away after a week or two.  On rare occaisions the seroma may persists for 4 to 6 weeks or longer and require treament with a sclerosing agent.

Seromas are not harmful if treated appropriately and not allowed to become infected. 

A seroma is not rare after a tummy tuck. In fact, it is the most common complication in some series (10%). In order to minimize these numbers, it is always best to leave a drain in you for long enough until the output is less than 25cc per day. This usually takes 7-10 days after surgery and longer in patients who have had massive weight loss. Doing this, I haven't had to drain a seroma in the last three years.

Seromas are harmless and won't alter your result as long as they don't get infected. Serial aspirations and occasional replacement of a drain will almost always resolve them.

You know if you still have a drainable seroma if you tap on the side of your lower abdomen and a fluid wave like a water bed flows across the abdomen to the other side. If you aren't sure, just go back to your doctor and they will take care of you.

Patients undergoing a tummy tuck procedure are often some of the happiest people I see in my clinic in Foster City, California.  There are some risks and potential complications with tummy tucks though and seromas are probably the most common complication.  In fact, I don't even consider a seroma a complication, they are more of a nuisance.  A seroma is a fluid collection that occurs typically once the surgical drains are removed.  Now that the body doesn't have the drains to rely on to rid of the post operative surgical fluid, in about 15% of the cases, fluid can build under the tummy tuck flap.  There are different ways to handle the fluid.  Most commonly, I will have my patients come back to the office about every three days to assess for seromas.  If I do encounter a collection, I will drain it with a syringe as your surgeon is doing with you.  If I have a patient who lives further away from the office, I may change to a different type of drain that requires placement into the fluid collection via a small incision within the tummy tuck scar.  This drain will then allow all fluid to leak out onto some gauze that can be changed as needed, its called a Penrose drain.  With this technique, I have cured everyone who has a longer standing fluid collection.  Typically, a detectable fluid collection will eventually resolve within 3-6 weeks provided the surgeon is aware of the situation and is providing the necessary treatment.  Hope this helps!!

Thanks for the question.

Seromas are a common problem after tummy tuck. Drains that are typically placed at the time of the surgery help reduce the amount of seroma.

Even in abdomens that look flat after abdominoplasty there is typically some amount of fluid under the flaps.

When this fluid is palpable or visible then it can be treated through aspiration. Typically as your body heals less fluid will be recruited into the area and your lymphatics regenerate.

Small seromas can be persistent for a very long time (even years). Symptomatic seromas (ones you can see or feel) can be treated by serial aspiration or by injection of sclerosant (typically antibiotics) with aspiration.

I hope this helps.

Seromas occur fairly commonly after abdominoplasty and are usually treated just as your doctor did. The can either be drained with a needle over and over until they go away or a drain can be placed. The very small amount of fluid that your doctor told you would resolve should absorb rather quickly. Occasionally a seroma can be persistent and require other procedures to remove them. 40 days is certainly not in the "unresolving" category. If it does not continue to improve an ultrasound can be done to assess how much, if any, fluid is still present. I would continue to see your doc frequently to keep an eye on this issue. As long as the fluid is not infected (and most seromas are not) it should not be harmful.

Aspiration of a seroma once it is seen is the correct procedure to be following.  I think your Plastic Surgeon is following you properly.  A small remaining seroma may take several weeks to resolve, possibly as long as a month or two, but I want to add one note of caution- if a seroma remains for too long of a time it will form a bursa or sac around it( a sac or bursa is made of scar tissue just like the capsule of scar that surrounds a breast implant).  If this were to occur, the seroma will not absorb and may become infected.  Certainly it would prevent the skin from tightening down to the muscles underneath and you would have a slightly distorted abdominal appearance.. If a sac does form and the seroma has not absorbed properly over the span of several weeks the best approach for your surgeon to follow might be to open the area up surgically and drain the seroma with a drain, excising the bursal sac entirely.  This rarely is required.

Be sure and follow the advice of your Plastic Surgeon. 

Good luck.  Frank Rieger M.D. Tampa

Seromas are a common complication of Tummy Tuck surgery. As long as the elevated skin/fat component has not completely adhered to the underlying muscle surface, the body continues to produce a varying amount of fluid. Most of the fluid IS absorbed by the body but when the ability of the body to absorb the fluid is slowed or over-passed fluid collections (Seromas) form and need to be drained. The drainage is done BOTH to allow the surfaces to stay in contact and stick together and to prevent potential infection or creation of a chronic pocket (bursa). Although frustrating, frequent syringe aspiration and less commonly drain placement usually resolve the VAST majority of seromas.

Dr. P. Aldea

As other physicians have said here, seromas are not uncommon after surgery. Those of us with low rates of postoperative seromas usually leave drains in following abdominal surgery for a longer period of time. Once a seroma forms, percutaneous aspiration is the usual therapy as you've described. It is also true that your body contributes to seroma resolution by absorbing the fluid over time. Sometimes chronic seromas can form where the wall of the seroma becomes thicker and better absorption does not happen. This occurs in a minority of cases.

If your physician had aspirated your fluid collection and you now have no clinical evidence such as bulging or apparent fluid below the skin, it is likely that the seroma is either completely resolved or on its way to being so. If however you have reaccumulation of the fluid which is also common, further aspiration may be necessary. The fluid collection, unto itself, is unlikely dangerous to you unless it gets infected. Things to watch for would be a fever, redness, or increased pain.

Without those signs, it is very unlikely that she need to worry about anything. In fact if it does not appear that you have excess fluid reaccumulated in that area, it is very unlikely that you have a residual problematic seroma. No further tests would be required aside from examination by your plastic surgeon on a normal scheduled basis.