How long does it take for a pseudo bursa to form? (photo)

Without knowing all the details of your surgery (and surgeon) I can only give you general information. However, draining 410cc of fluid 3 weeks post-op sounds problematic to me. Here's why:Did you have drain(s)? If so, how long has it been since drain removal? You didn't develop 410cc in a day or two--fluid has been present and increasing since surgery (or since drain removal).Why did you wait so long before aspiration? 410cc is a large volume of fluid that must have been clearly evident. Did you not have recheck appointments with your surgeon? Did you not call for a sooner appointment when (that much) fluid build-up became evident?Have you been wearing any sort of abdominal compression to help adhere the tissue layers together and retard the build-up of fluid?What did your surgeon tell you after aspirating 410cc? Are you returning in a few days for more aspiration? An appointment in a week or two is too long for more fluid to be left there, and increases the risk of pseudobursa.I  can only assume you had surgery by an ABPS-certified plastic surgeon, but this lack of follow-up and delayed treatment of fluid does not sound like optimal care.This is also an all-too-common result of "I don't use drains--they are unnecessary" BLAH BLAH BLAH or "My patients don't need abdominal binders or compression" BLAH BLAH BLAH. Lots of talk and "marketing" but yours is not an uncommon situation. Don't get me wrong; there are many of my equally well-trained and competent ABPS-certified plastic surgeons who will not use drains or compression binders or garments, but they generally take measures to minimize these sorts of problems, or treat them aggressively when they (hopefully rarely) DO occur. I don't know what was done to minimize these risks in your case, and it certainly doesn't appear as if draining 410cc 3 weeks after surgery is "aggressive" enough to eliminate further fluid build-up.You ARE at risk for development of pseudobursa, and this usually requires surgical treatment. Who pays for that, not to mention your time off for another operation? Sclerotherapy may be an option, but your surgeon needs to administer that, and you may require re-insertion of a drain to facilitate sclerotherapy and drain off persistent seroma fluid to increase the chances of successful sclerotherapy.Schedule another appointment with your surgeon ASAP. This fluid should not be allowed to persist and build up--tissues cannot adhere and heal if there is a fluid layer between them. Best wishes! Dr. Tholen

There is no specific amount of time that can be defined for the formation of a pseudo bursa.  There are multiple factors that contribute to its formation.  What is know is that the sooner you can get a seroma treated and resolved, the better. Discuss this matter further with your surgeon.

The formation of pseudobursa is variable from patient to patient depending on the type and amount of seroma.  The more inflammation there is the higher the incidence of pseudobursa and likely the faster its formation.  If large or repeated seromas are present a drain may be considered.  Once large pseudobursa formation occurs full correction often requires surgical removal.  The video below shows removal of a pseudobursa during a full tummy tuck revision.All the best,Dr. Remus Repta