Hello doctors, Story: I had a Drainless TT on 04/04, and on 04/09 I developed a seroma. PS aspirted it multiple times, then inserted drain, then scleoring agents 3 times, and nothing worked. I am now scheduled for surgery to remove the seroma. My PS is not experienced in this complication, as he said he's never seen a seroma this persistent. I am looking for experienced surgeons in seroma removals around my area, and prices for this type of procedure.
Answer: Surgery for an abdominal seroma It sounds like the surgeon needs to open the incision, explore and place a drain. Drainless tummy tuck is not very commonly performed - some surgeons do it and market it as the patients find it appealing to not use a drain. I have not found this to be possible and I always use drains at the time of tummy tuck. Draining a seroma is not complicated and persistent seromas are something I would think any plastic surgeon has seen. Yes, it is possible the seroma will not stop with a drain placed. In that case you would be fine getting a second opinion.
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Answer: Surgery for an abdominal seroma It sounds like the surgeon needs to open the incision, explore and place a drain. Drainless tummy tuck is not very commonly performed - some surgeons do it and market it as the patients find it appealing to not use a drain. I have not found this to be possible and I always use drains at the time of tummy tuck. Draining a seroma is not complicated and persistent seromas are something I would think any plastic surgeon has seen. Yes, it is possible the seroma will not stop with a drain placed. In that case you would be fine getting a second opinion.
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Answer: Seroma after abdominoplasty Seromas or fluid collections are one of the most frequent complications of abdominoplasty. Using an abdominal binder firmly applied to the abdomen with cotton roll under neath is the protocol I use for 30 days after surgery or seroma aspiration. It is important to limit activity for 30 days after last aspiration or surgery. It takes several weeks for the Timmy skin to stick back down. Sedona excision is a simple procedure. An ultrasound, MRI or Ct scan may help to be sure of the diagnosis. Sometimes a hernia is the culprit. I have removed a late aeroma but have never considered excision before six months. It can take persistent aspirations or drains for two months with limited activity and form compression to be rid of this nasty complication. Good luck and be compliant.
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Answer: Seroma after abdominoplasty Seromas or fluid collections are one of the most frequent complications of abdominoplasty. Using an abdominal binder firmly applied to the abdomen with cotton roll under neath is the protocol I use for 30 days after surgery or seroma aspiration. It is important to limit activity for 30 days after last aspiration or surgery. It takes several weeks for the Timmy skin to stick back down. Sedona excision is a simple procedure. An ultrasound, MRI or Ct scan may help to be sure of the diagnosis. Sometimes a hernia is the culprit. I have removed a late aeroma but have never considered excision before six months. It can take persistent aspirations or drains for two months with limited activity and form compression to be rid of this nasty complication. Good luck and be compliant.
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May 22, 2017
Answer: Chronic seroma Sorry to hear that you are having continued issues following your surgeries. It sounds like your surgeon has taken the appropriate steps. Seromas can occur in 5-10% of patients and even higher (up to 40-50%) in weight loss patients. The treatment for a refractory seroma is to completely excise the seroma cavity and then place and drain and use compression. You should also make sure that your protein intake is high as this will minimize the risk of fluid collections. I have had to do this procedure several times, mainly in my weight loss patients due to the increased risk. Some insurance companies may help, but many do not cover the costs of complications related to cosmetic surgery. From a cost standpoint, seeing your surgeon will be the most cost effective. I hope that this situation resolves for you.
Helpful
May 22, 2017
Answer: Chronic seroma Sorry to hear that you are having continued issues following your surgeries. It sounds like your surgeon has taken the appropriate steps. Seromas can occur in 5-10% of patients and even higher (up to 40-50%) in weight loss patients. The treatment for a refractory seroma is to completely excise the seroma cavity and then place and drain and use compression. You should also make sure that your protein intake is high as this will minimize the risk of fluid collections. I have had to do this procedure several times, mainly in my weight loss patients due to the increased risk. Some insurance companies may help, but many do not cover the costs of complications related to cosmetic surgery. From a cost standpoint, seeing your surgeon will be the most cost effective. I hope that this situation resolves for you.
Helpful
May 22, 2017
Answer: Chronic seroma Dear Maru, Sorry to read about your problem. A front and side view picture would have been helpful. Your condition is very rare and I have done it once or twice in my 30 years practice. It is possible that you have developed granulomas in the seroma pocket , which cause the constant filling of the pocket with fluid. I hope that cultures were sent to the lab and came back negative. The treatment for chronic seroma is to excise the lining of the pocket and create raw surface that will stick and eliminate the cavity. I would recommend to leave a drain for few days, which will help the cavity to scar down and disappear. Your best option (financially) is to let your surgeon do it, however, if he declines to do it , or you lost confidence in him, consult with other, local experienced board certified plastic surgeons.The procedure will take 1-2 hours, depends on the size of the cavity. Best of luck, Dr Widder
Helpful 1 person found this helpful
May 22, 2017
Answer: Chronic seroma Dear Maru, Sorry to read about your problem. A front and side view picture would have been helpful. Your condition is very rare and I have done it once or twice in my 30 years practice. It is possible that you have developed granulomas in the seroma pocket , which cause the constant filling of the pocket with fluid. I hope that cultures were sent to the lab and came back negative. The treatment for chronic seroma is to excise the lining of the pocket and create raw surface that will stick and eliminate the cavity. I would recommend to leave a drain for few days, which will help the cavity to scar down and disappear. Your best option (financially) is to let your surgeon do it, however, if he declines to do it , or you lost confidence in him, consult with other, local experienced board certified plastic surgeons.The procedure will take 1-2 hours, depends on the size of the cavity. Best of luck, Dr Widder
Helpful 1 person found this helpful
May 22, 2017
Answer: Persistent seroma. Thanks for your question. I am sorry to hear you are having issues. Seroma can be frustrating and it sounds like your PS is taking the right steps. A drainless or quilted tummy tuck is usually an effort to prevent this complication in the first place. When a seroma persists the treatment is to go back in, remove the lining of the cavity if possible or abrade it so that the tissues will stick to one another again and quilt again. If there is any permanent suture material it may need to be removed. Depending upon the location of the seroma, and the suture material used the surgery may be smaller or similar to the scope and cost of an original tummy tuck. If you have a long lasting, but dissolvable plication suture the seroma may resolve when it is gone. All PS's try to prevent seroma so I think it would be hard to find a seroma specialist. Seroma is an unfortunate risk of this type of surgery. It sounds like your PS is doing the right things and still may be your best bet.
Helpful 1 person found this helpful
May 22, 2017
Answer: Persistent seroma. Thanks for your question. I am sorry to hear you are having issues. Seroma can be frustrating and it sounds like your PS is taking the right steps. A drainless or quilted tummy tuck is usually an effort to prevent this complication in the first place. When a seroma persists the treatment is to go back in, remove the lining of the cavity if possible or abrade it so that the tissues will stick to one another again and quilt again. If there is any permanent suture material it may need to be removed. Depending upon the location of the seroma, and the suture material used the surgery may be smaller or similar to the scope and cost of an original tummy tuck. If you have a long lasting, but dissolvable plication suture the seroma may resolve when it is gone. All PS's try to prevent seroma so I think it would be hard to find a seroma specialist. Seroma is an unfortunate risk of this type of surgery. It sounds like your PS is doing the right things and still may be your best bet.
Helpful 1 person found this helpful
