10 years post op and still feel swelling and fluids - what are my options to correct this?

Question

I got a TT over 10 years ago. My question is I feel and can see there is still fluid, like edema. My doctor that did my procedure would put a needle in there and suck out the blood and fluid. He has since retired. What are my options? I am in great shape but this is annoying. Any suggestions you can offer me

J. Timothy Katzen, MD, FACS · Answer

It's not common to experience swelling and fluid retention ten years after a tummy tuck, but I understand your concerns. First and foremost, I recommend consulting with a board-certified plastic surgeon who can evaluate your condition and provide the most appropriate recommendations based on their assessment.

There could be several factors contributing to the persistent swelling and fluid accumulation, including underlying medical conditions, lymphatic obstruction, or even scar tissue. It's essential to have a thorough examination to determine the cause and discuss potential treatments. Options may include further drainage, ultrasound-guided aspiration, or even revision surgery, depending on the underlying issue.

I'm sorry to hear that your previous surgeon has retired, but finding a new, experienced plastic surgeon will be crucial in addressing this issue effectively. I hope this information helps, and I wish you the best of luck in finding a solution to your concerns.

Thank you for your question, and best of luck on your journey.

Sincerely,
Dr. Katzen

Alan Gonzalez, MD, FACS · Answer

Hello @Nice89602, thank you for your question. It is important to take into account several aspects among which is the surgical technique applied, and to evaluate if there is something else at a systemic level to make you still swollen and with fluids. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs.  Best wishes!  Alan Gonzalez MD FACS   Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Daniel Barrett, MD · Answer

Dear Nice89602,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Miguel Mota, MD · Answer

Hi. If it’s been 10 years and you still have fluid or seroma on your abdomen, you should get an ultrasound done to confirm a chronic seroma; a pocket of fluid between the skin and abdominal muscles months or years after surgery. 
The problem is that scar tissue forms like a balloon around a chronic seroma. This tissue doesn’t stick back together and the body continues to produce liquid to fill out the space. Once this is confirmed, surgical removal the balloon-like tissue that is surrounding the seroma needs to be performed.  To correct and avoid future seromas,  the scar tissue is removed and special sutures are put in place so the remaining tissue will heals on to each other.

Best of luck,
Dr. Miguel Mota

Connie Hiers, MD, FACS · Answer

Fluid still present ten years after a tummy tuck would be rare. I would suggest finding another surgeon to see you and get an ultrasound to check for fluid. You may have an organized seroma which will need to be removed surgically.

Camille Cash, MD · Answer

What you are describing is not typical ten years after surgery.  I encourage you to visit another board certified plastic surgeon in your area for an evaluation.  An ultrasound or other tests may be needed to determine what is causing your concern.

Douglas Taranow, DO, FACOS · Answer

If you can see and feel the fluid 'wave', then you have a seroma (clear or yellow fluid collection).  At this time, it is a permanent collection usually with a well developed wall).
Options are:
Leave it in place
Serial needle drainages with steroid injections to try to reduce the reaccumulating of fluid (I doubt this will ever work at this stage)
Interventional radiology-they can use a sonogram to locate and drain the fluid pocket.  They may inject a sclerosing agent which can collapse the pocket and make the walls stick together. 
Lastly, surgery to open the pocket and remove the seroma lining and stitch the pocket closed.
Best wishes,
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. It sounds like you may have a chronic seroma. Fluid collection needs to be managed aggressively and correctly as soon as it’s identified after surgery in order to prevent it from becoming chronic. Once a Chronixx aroma has formed, it can no longer be treated by just removing the fluid. A chronic Sarama has created an encapsulation, and to now treated requires removing the capsule and placing a drain. removing chronic seromas is generally covered by medical insurance and should not be considered a cosmetic procedure. Talk to plastic surgeons in your community, especially those who do insurance-based reconstructive surgery and ask for a consultation to see if you have a chronic seroma. Potentially you could start it with your primary care doctor, who could order an ultrasound, which could help confirm the diagnosis or simply ask for a consultation with any plastic surgeon in the community to get you an assessment. You may not have a chronic seroma, but from what you describe, that is a distinct possibility. 
Best,
Mats Hagstrom, MD

10 years post op and still feel swelling and fluids - what are my options to correct this?

Answers (8)

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