Lip over Incision 5 Weeks Post Mini TT -Seroma Removed 2x. Is the Swelling and Lip Ever Going to Resolve? (photo)

There are several questions within your main question, so I will approach them one at a time.  First, will the seroma ever go away?  The answer, of course, is yes.  I am sure your plastic surgeon is as frustrated as you are.  There are several mechanisms your plastic surgeon can employ to make this recurrent seroma cavity shrink up and finally go away.  Obviously his or her suggestions are the ones you should follow, but if you were my patient, I would first try to inject a little corticosteroid after draining out some of the fluid.  If this doesn't work, then very often, placing liquid tetracycline in the pocket and putting pressure on the pocket after draining the fluid, can often cause the pocket to obliterate.  As a final resort, reopening the abdominoplasty incision, taking out the wall of the seroma which is presently secreting the fluid, and then closing the incision after quilting (putting lots of sutures in to bring the skin and fat down to the muscle) will certainly get you past your seroma problem.

Secondly, you want to know how to get rid of the overhang that has been created at your suture line by the seroma.  The answer is time, pressure, and in my practice, we use ultrasound (the kind physical therapists use for sore muscles).  The lip present over your suture line is really organized swelling, and if treated aggressively with ultrasound, will dissipate and never become true scar tissue.   

This is an unfortunate complication that can happen with any form of tummy tuck.   I think you are doing all the right things and I recommend that you continue to wear your binder snug.   


You should see resolution of the lip and swelling over 3 months.  I wish you a safe and healthy recovery.

Persistent seromas can be a nagging complication as you have no-doubt realized. Unfortunately, they can also lead to stretching of the skin in a situation where contraction is the goal. At 5 weeks, it is too early to count out skin contraction. The lip of skin may improve over the next few months. Regardless, no revision would be advised until at least 3 months and more preferrably 6 months. With recurrent seromas, the late issue becomes a seroma capsule which may need to be excised.

When seromas occur they can be troublesome, and your casehistory demonstrates. Assuming there is no more seroma, what you are looking at is a predictable amount of swelling, consequent to the recurrent seromas. 

Should you get more fluid accumulations, you and your surgeon should consider sclerosis, a procedure in which a substance is injected to encourage the  edges of the fluid cavity to stick to each other and thus stop secreting serum . Various agents can be used, including betadine, tetracycline, mustard (not the hot dog kind), absolute alcohol.
 

Once this is resolved some patience will be needed to allow several months for the swelling to resolve. The there is still excess skin, it could be removed in a relatively minor procedure under local anesthesia.

Thanks, best wishes.

Unfortunately this is not an abnormal complication and should resolve over 3-6 months.  Massage in this area will be very beneficial when your doctor allows it.  The swelling above the incision will go down over time but with the seroma the clock starts all over again so just be patient and follow up with your doctor.  Good luck, Dr. Schuster in Boca Raton.

Sorry for the complication. Best to have a revision in 6 months. This allows full healing and maturation of the scar.