Why do I keep getting a reoccurring seroma?

This is not the usual case and so I think you need to see both your plastic surgeon and your general surgeon.I would cuilture the fluid and have it analyzed to see if it is lymph fluid.Agasin this is not the normal course.

Seromas are common following tummy tuck but they usually resolve in a couple of weeks. Persistent seromas may be caused by medical illnesses which must be ruled out such as congestive cardiac failure, renal failure and low blood protein.

If your lymph nodes were damaged during the hernia repair, you may even have a lymphocele where it is lymph fluid that is gathering and not (only) serum.

Assuming this is not the case with you, conservative measures would include cortisone (Kenalog) injections into the seroma cavity after draining the fluid out and ensuring that no infection is present. This reduces inflammation - a cause of serum production. Another simple approach is the (re)insertion of a drain. I have never seen sclerosing solutions work for this problem.

If these do not succeed, then the wound should be opened, the seroma cavity lining excised and the abdominal flap quilted down to the underlying abdominal muscle fascia with dozens, if not  hundreds, of sutures - so obliterating the seroma space.

Good Luck. I used to practice in Fort Lauderdale. There are many excellent Board Certified Plastic Surgeons there.

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