I had a tummy tuck/lipo on Oct 1. Drain was out 11 days postop when there was still drainage of about 30-40/day. Last Thursday, my pubic area was hurting and incision was swollen above. There was a wavelike motion when i would touch the stomach. I called the PS and he put in a seroma cath on Friday. Within 6 minutes, there was yellow-clear drainage of 200 ml. Within the rest of the day another 100. it has consistently been about 75-100 a day.normal? Why is there so much drainage now? advice please.
October 23, 2010
Answer: Seroma and Tummy Tuck Patient are different from one to another therefore some patient produce more fluid than others. This area is rich in lymphatics which produces the fluid. Equally important if there is a large amount of fat in the area there tends to be more fluid produced. I usually recommend removal of the drains when the production is less than 25 ml/day.
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October 23, 2010
Answer: Seroma and Tummy Tuck Patient are different from one to another therefore some patient produce more fluid than others. This area is rich in lymphatics which produces the fluid. Equally important if there is a large amount of fat in the area there tends to be more fluid produced. I usually recommend removal of the drains when the production is less than 25 ml/day.
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Answer: Seroms after Tummy Tuck Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.Best wishes,Pablo Prichard, MD
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Answer: Seroms after Tummy Tuck Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.Best wishes,Pablo Prichard, MD
Helpful 1 person found this helpful
