In what stages after a tummy tuck can a Seroma develop ?

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. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.Best wishes,Pablo Prichard, MD

It would be more likely to occur early on within the first 6-8 weeks. Being that said it can happen further out as well. Sometimes patients get too aggressive with activity too early and they can cause a tear that leads to a seroma or a hematoma. Sometimes drains are removed and then the seroma occurs. There is no right or wrong answer here, but usually it occurs early on after surgery. By 6 weeks the abdominal skin should have scarred back down to the overlying muscles and there should not be a problem. One thing I have learned as a surgeon, anything can happen to anyone at any time.

Thanks for your question. A seroma is a collection of fluid underneath the abdominal skin. It can be related to a low grade infection, an undetected bleed (where the blood breaks down into straw coloured fluid) or the ongoing drainage of lymph fluid. Drains are usually kept in until the drainage is less than 30-40mls in 24 hours. Techniques to prevent seroma include suturing the abdominal flap down to the abdominal wall, preserving the lymphatic vessels in the lower part of the abdomen (by leaving a layer of fascia over the muscle) and leaving the drains in until they stop draining.A seroma usually develops within 6 weeks of surgery, although I have seen revision cases where there was an undetected seroma deep in the wound that wasn't causing any issues. The treatment for a seroma is drainage, either under ultrasound guidance or using a needle in the rooms. Recurrent seromas may require surgical exploration and re-insertion of a drain.I hope this helps.