Seroma treatment - I'm almost 5 weeks post op mommy makeover. (photo)

Question

I had a drain until day 19 due to not being able to bring down the fluid level. A seroma developed and was drained (30cc) a week later. Now I've noticed it's coming back again. The dr said to "call when I feel like it needs to be drained again". I don't know when this is and he wouldn't explain more. There is a bulge mid incision and waves to front hip when pushed. How much fluid is too much?

Steven M. Lynch, MD · Answer

Hi,  This decision should not be put on you.  Your doctor should walk you through the resolution of the seroma.  If you have a fluid wave, then that would indicate to me that more than 30 cc's (essentially 2 tablespoons.....or 6 teaspoons)is present and necessitate drainage.  Be careful to not wait too long as the fluid can build a scar capsule around it as time goes on.  There are many ways to resolve this issue besides seroma drainage.   See your doctor and get this resolved.

Erika Sato, MD, FACS · Answer

A seroma is a normal complication of liposuction or a tummy tuck. You usually know it is present because it has a fluid wave easily felt when you hit a bump in the car etc. If it continues to accumulate then it is too much. Your body can absorb ~30cc of seroma fluid per day and anything in excess to that will accumulate. This fluid can get infected and can compromise your results if your body develops a rind around the fluid. This happens when the seroma is not taken care of properly. There are things that you can do to help this resolve. Stay away from alcohol and salty food and wear very tight compression 24/7. I start my patients on a water pill to help them get rid of excess fluid. You  must be in close contact with your PS as this is time sensitive. It is also an option to place a seroma catheter instead of draining the fluid every few days.

Remus Repta, MD · Answer

Thank you for the question and photo.  I think every seroma that can be identified should be drained.  This helps the two layers of the tummy tuck healing back down and reduces the incidence of scar tissue and pseudo-bursa.  Compression of that area and limitation of activity is also recommended.  I would discuss these items with your plastic surgeon.  In the end, it will be your plastic surgeons preference that you will be following.All the best,Dr. Remus Repta

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and sorry for the complication though it is all too common but can be reversed with aspiration and instillation of 5FU/Aristocort or antibioticsDr. Corbin

Arian Mowlavi, MD, FACS (license on probation) · Answer

Seromas after tummy tuck can be resolved with:1)serial aspiration2)compression3)antibiotics that are guided by the aspiration (send it for culture).

Seroma treatment - I'm almost 5 weeks post op mommy makeover. (photo)

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