what can I do to get rid of a Seroma. Will it get worse, and what can I do so that fluid can self drain?

Question

I developed a seroma (in lower abdomen n groin area)when my drain fell out Friday evening after having it in for 4wks.I was still draining abt 45-50/day.on Monday my PS aspirated abt 110.and reopened drain site so that fluid could self drain...my question is, what can I do to get rid of seroma, will it get worse?and what can I do so that fluid can self drain?I push down on my lower abdomen to get rid of fluid building up but nothing comes out. very worried any advice would greatly be appreciated

Joshua Lampert, MD, FACS · Answer

Seroma after abdominoplasty is one of the more common complications that can occur.  Typically, these are small fluid collections that can be aspirated in the office and resolve rapidly after that.  Wide undermining of the abdominoplasty skin flap creates raw surfaces and space under the skin.  Raw surfaces can ooze serous (straw colored) fluid similar to the fluid that oozes when you scrape your knee.  Using drains and compression collapses the "dead space" under the skin and allows the raw surfaces to heal down and together.  This decreases the chance for seroma.  Sometimes a fluid pocket develops and can be aspirated rather painlessly in the office.  After a repeat aspiration, space collapses and the seroma usually resolves.  Much less frequently, a mature seroma cavity can develop.  This I have seen more in patients with poor nutrition or after bariatric surgery.  When this happens, the seroma may not respond rapidly enough to aspiration.  Typically this is not the case, but may require return to the operating room to remove the wall or "peel" of the seroma cavity and place a new drain. I would see an ABPSboard certified plastic surgeon for any and all abdominoplasty questions.

Omar Quaba, MA, FRCS (Plast) · Answer

Hi, it is a real shame that you had a drain in for 4 weeks. We do not use drains as there is no evidence that they prevent seroma. Having said that, your drainage was down to around 45-50 a day and many surgeons would take drains out at this point. The seroma will settle itself shortly. I would not worry if you cannot express any fluid out as long as your abdomen is not becoming distended and you are comfortable.
Sometimes seromas can become infected so look out for any redness or fever. As long as you feel well everything should settle down shortly.

Robert Whitfield, MD · Answer

It is important to have the fluid removed as has been mentioned already.  It might be helpful to have an ultrasound to see exactly where the fluid is especially if it is causing pain.

James Nachbar, MD · Answer

I'm sorry you are having trouble.  Seroma can occur after tummy tuck when a drain is relied upon to remove the fluid, which is one of the reasons I have done my tummy tucks without a drain since 2008.  When the no-drain technique is performed properly, seromas rarely if ever occur, but there is a learning curve to this more complex technique.The good news is that seromas are not generally dangerous, but more of a nuisance.  The treatment is to remove as much of the fluid as frequently as possible to allow the tissue to heal together and remove the space where fluid can collect.  If you can keep an opening draining, that would be great, but it is hard to keep it open without a drain in place.More often, the best management is to use a needle to drain the fluid every couple of days for a couple of weeks.There is also a "Seroma-Cath" that can be used as a "drain placed after surgery" -- this is like a big intravenous line, which is a plastic tube introduced into the fluid collection and left in place for a while to continuously drain the seroma.However, most of the time, the seroma can be treated without placing a Seroma Cath.Good luck!

David Finkle, MD · Answer

Seromas are fluid collections that can occur after a surgical procedure.  They are very common in tummy tuck procedures, even with drain placement.  Some things you can do to help the situation are wearing a tight binder or a spanx will help compress the area where the seroma has developed.  Also, abstain from vigorous physical activity until the seroma has resolved.  It sounds like your plastic surgeon is on top of the problem, follow his/her advice closely.

Brooke R. Seckel, MD, FACS (retired) · Answer

Please see your plastic surgeon for an examination and diagnosis and treatment plan.  Aspirations of seroma requires sterile technique.If you have a fistula that is an open draining seroma at 4 weeks the risk of infection and a permanent fistula is possible.You need to see her plastic surgeon for an examination and diagnosis.  He or she may need to open the area to resect the seroma cavity and close the wound.  Do not try to manage this yourself.

what can I do to get rid of a Seroma. Will it get worse, and what can I do so that fluid can self drain?

Answers (6)

More Tummy Tuck Questions

WE SEND PRETTY
EMAILS

Answers (6)

More Tummy Tuck Questions

I really want my belly to look flat and tone. Will a tummy tuck work for me? (photos)

Is it common to have full sensation and then go completely numb two weeks after Tummy Tuck?

Dark bleeding from my incision. Is it normal?

How long do your tummy muscles hurt after tummy tuck?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS