How common are seromas after a tummy tuck (national average)?

Thank you for sharing your excellent question.  Seromas of all sizes have been reported in up to 25% of abdominoplasty cases, with the vast majority small enough to not be noticeable by the patient or physician.  Clinically significant seromas average less than 5% of tummy tucks.  There are various treatments offered by surgeons to try and reduce this risk, including drains, quilting stitches, progressive tension sutures, tissue glues, etc.  Each physician has their own protocol and it would be best to discuss their preferred method.  Hope this helps.

The problem with establishing the overall risk of seroma's was abdominoplasty is difficult because of the variation from surgeon to surgeon doing the operation. Significant seroma's occur less than five of the time. Small seroma's that are easily aspirated in the office or more common, perhaps as high as 10%.

During a tummy tuck, the skin/fat is separated from the muscle layer from the pubic area up to the ribs.  This leaves a potential empty space that can fill up with fluid which is known as a seroma.  Doctors can minimize the accumulation of fluid by using progressive tension sutures (which close off the potential empty space) and drains (which suction out the fluid).  If the drains are pulled out too soon, the fluid that would normally be evauated through the drains now accumulates under the skin.  Sometimes this can be eliminated by inserting a needle through the skin into the fluid pocket and removing the fluid that way.  This may need to be done a few times.  I don't know the exact statistics on seromas but it is not an uncommon problem with tummy tucks.  Fortunately, it is usually a fairly easy problem to correct.

Seromas are not related to poor technique but one thing that has been shown is that the rate is lower with the use of progressive tension sutures, which I have been doing for almost 20 years. The usual definition of a seroma is a fluid collection that develops under the skin after the drain is removed (or if no drain was used.) The problem with this definition is that you can have a drain in for weeks but not have it considered a seroma. I use drain with the PTS technique and they can usually be removed within a few days.

In my opinion serums are related more to surgical technique than any other factor. incidences of serums can be up to 30% in some reported series and can be reduced by certain intraoperative techniques. The attached blog and reference is worth reading. I personally don't use drains and have not seen a seroma with this described technique.