Encapsulated Seroma turned to Scar Tissue in Abdomen - Can Liposuction fix this or do I need a Tummy Tuck revision? (photos)

Unfortunately it is difficult for liposuction to correct this. If there is significant subcutaneous fat superficial to the mass, it may be possible to liposuction in this area and reduce the fullness but not remove the bulge which is likely scar tissue that forms around the seroma. The most definitive correction is to go back in and remove the seroma capsule. Unfortunately this involves the cost of surgery/anesthesia on top of the prior abdominoplasty cost. Maybe you can talk with your surgeon about a way to reduce these costs.

I have never had to operate to resolve a seroma. I assume the fluid filled seroma is still there although you don’t mention it specifically. You should have a penrose drain placed in the cavity and brought out through the belly button scar. It then needs to remain in for a week. The fluid will drain to the outside. The drain is simple to place while awake. It has to be an open PENROSE drain. Any other type of drain won’t work. I have 100 percent success rate with this but many surgeons aren’t aware of this technique. It relies on a very old principle called dependent drainage which you should read up on. It only been around hundreds of years but still is the best solution. I have NEVER had this method fail in 35 years of practice and remained amazed about other surgeons not doing this.

Dear Gcderouen,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks fir side viewed only posted photos, where are front views? It seems only re operation of the TT scar revision and dissection of the capsuled seroma are the recommended options. Expect fees from $8,000+++Best to virtual consult with... Many questions- Was muscle plication done? Did it fail?Was attempts to needle aspirate the seroma attempted? Where was the TT surgery & by whom?

Seroma formation is the most common complication after a full tummy tuck. it’s typically related to having the drains removed prematurely but can happen despite leaving drains in for a sufficient amount of time.
The best treatment is a Daly aspirations until it’s no longer recur.
Any significant amount of time with a seroma left undrained worse since the situation since with fluid inside the tissue surfaces are not in contact.
If not treated aggressively by continuous draining with daily visits or the placement of a drain the fluid buildup will develop a scar tissue lining called a capsule.
Once encapsulated the seroma can no longer be treated by aspirations and will recur despite how frequently aspirations are done.
The treatment for a chronic or encapsulated seroma is direct surgical excision. this is gonna be done either by going through your old tummy tuck incision or making a new incision directly over the seroma. After excision of the capsule and drain needs to be placed to reduce the chance of the fluid collection returning
Your pictures show your abdominal wall bulging a significantly. It looks to be more than what a typical seroma would cause.
You may have excess visceral or intra-abdominal fat that’s pushing against the muscle wall.
All plastic surgeons should be able to manage a arooma competently.
Follow up with your provider. If that is not sufficient then consider getting an in person second opinion consultation.
The treatment of a seroma is a medical condition and surgery for this can be billed to medical insurance as a medically appropriate procedure.
Best,
Mats Hagstrom MD

Liposuction will not remove the scar tissue. Massage and ultrasound treatments (Aspen) may help without the need for surgery. I recommend against triamcinolone injections (anti-inflammatory steroid) because the risk of hypopigmentation (a lighter spot on the overlying skin) or fat atrophy (an indentation over the scar) is too great. If you can't live with the scar then the most effective method would be a revision abdominoplasty. A bulge in this area following tummy tuck could also be recurrence of the rectus muscle diastasis (separation) from broken or ripped internal sutures, which would require surgery to correct (I am assuming the CT scan ruled this out). It is best to return to the surgeon who performed your tummy tuck so that she or he may assess the situation in person. Good luck, Jeffrey DeWeese, MD, FACS