FDL Revision Needed? (Photo)

Sorry to read about the issues you have been having after your surgery. Unfortunately it does look like you may need a revision procedure to remove more of the redundant skin. At this point, I would wait a minimum of 4-6 months, allow all the swelling to dissipate and then go back in to remove the extra skin. This would not be as extensive as your original procedure, but it still is surgery and would require downtime.

Hope that helps.

Tummy tuck seroma is simple to resolve. The surgeon needs to place a Penrose drain ( no other type will work) into the seroma space through your existing incision and let the fluid flow freely to the outside where you can place some gauze pads. Remove the drain in a week. Problem solved. I’ve done this enough times and it never fails. I do think you need your incision a bit lower but that revision can wait six months

Dear LovingMyChronicLife,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Yes, this will need to be revised and will require removing the entire cavity of the seroma and leaving drains for at least 2 weeks. Please discuss this with your surgeon.

The seroma and skin laxity needs to be addressed by your surgeon. The current result could definitely be improved. At nine weeks post op you can still expect changes in the future but I'm not sure it will improve to the degree where no further revision is recommended.

Based on the nicely posted photos you need removal of the seroma pocket with revision of the excess skin inferiorly. fee in the $10,000 rages. best to virtual consult with....

Many years ago when I was a resident I was in a conference and I remember one of the speakers made this statement “ i’ve never regretted putting in a drain“.
Everybody in the audience knew exactly what he meant. Drains are annoying and have certain drawbacks. In particular they are uncomfortable and leave additional scars.
If the fluid collection builds up they are an absolute necessity.
Plastic surgeons should know how to manage a postoperative seroma.
The correct treatment is either placing a drain or draining the fluid on a regular basis preferably daily until it no longer occurs. This could mean coming into the plastic surgeons office on an almost daily basis for several weeks.
If the fluid Collection is allowed to accumulate the two tissue surfaces are not in contact and cannot heal.
The more time that’s spent with fluid in the pocket the worse the situation gets so having it drained regularly or placing a drain for continuous drainage is what is the best.This seems to happen fairly commonly and too many plastic surgeons sick their head in the sand pretending the problem it’s going to resolve by itself.
They don’t and eventually patients end up with an encapsulated chronic seroma that can only be treated by open excision.
You are an hour outside the window where the seroma can be treated by using a drain. This includes all the various things people of tried like injecting steroids or sclerosing agents.
If your surgeon didn’t want to put in a drain he should’ve considered referring you to an interventional radiologist Who can place drains without opening the incision. Having a drain placed for a seroma related to cosmetic surgery is still a medical condition and would be covered by medical insurance.
Had your surgeon done that as soon as the Seroma was recognized then you would be off at this point not having to deal with this.
At this point he will most likely need to have the seroma capsule exercised in the operating room with the placement of a drain that’ll probably need to stay in for a long time.
Attempts of getting the fluid collection to drain and stay closed without removing the scar tissue capsule substantially decreases long-term success.
If for some reason your provider has not learned how to manage a seroma correctly then you’ll need to consult with other providers who have the skill necessary.
These are pretty fundamental basics learned during internship in general surgery and should not be beyond with any plastic surgeon can competently manage.
Best,
Mats Hagstrom MD