When you have a persistent seroma after tummy tuck at what point is surgery needed & what are chances of it reoccurring? (photo)

I have seen this and I have come up with a solution that has always worked for me and I have never had to re operate for a seroma.  What I do is place a drainage tube called a pen rose drain through the incision into the seroma space.  It drains outside onto gauze and I leave it in for one week.  It creates a funnel which allows the fluid to completely drain and the seroma space to close behind it.   I have had it work every single time and would be happy to help you. It's a very simple technique that many surgeons haven't used.  

After eight weeks and a persistent seroma, the seroma cavity is probably established and may form a thick capsule, called a bursa.  At this point even if the seroma cavity can be obliterated, e.g., with doxycycline injection, the bursa may still be a problem. A bursa can feel like a thickened area on the abdominal wall which can be visible. When this occurs, the bursa can be removed with surgery. Although a seroma can occur with the initial surgery and a revisional surgery, at the time of re-operation quilting sutures can be used so there is no space for fluid to accumulate.  I use this method with tummy tucks initially, so I do not have to use drains. Because the space is closed off from the beginning, the chance of a seroma is almost eliminated.  This could be very helpful if revision for bursa removal is needed.

My experience is that multiple aspirations or another drain may be needed but the seroma will eventually resolve.  Surgery is rarely neededDr Corbin