How big does a seroma need to be before it can be drained?

Question

I had a tummy tuck 5 weeks again. They removed drains at 3 weeks exactly. The morning that they removed the drains I had drained 100cc in 24 hours between the two. PS said I would form a seroma or 2 and when they got big enough they would get drained. When I got my staples out last week family dr said that I had one but they would drain them until it looked like my skin was yellow around the seroma. That's when they knew they were big enough and then they knew where to aspirate. Is this right?

Erik Miles, MD, FACS · Answer

Drains for 3weeks and removed while still draing 100 cc?  Told to plan on seroma drainage when the skin gets yellow?   Staples in for 5 weeks?None of this falls within the realm of what I would expect after a tummy tuck.  There is variation among practitioners regarding how they do the procedure, however what you have described is beyond what I believe is considered standard practice.  There may be details about your procedure that are not mentioned, which might make more sense. For example, did you have a complicated panniculectomy procedure where there would be more chance of prolonged drainage and possibly staple closure?   If you were told that you underwent a traditional abdominoplasty, I  suspect that you might not have had your surgery done by someone who is certified by the American Board of Plastic Surgery.To answer your question, seromas of all sizes can be drained.  Obviously the larger the seroma, the easier it will be to drain.  Most of the time, the fluid accumulates in a gravity dependent position.  If a seroma is large enough to require drainage, then it should not be too difficult for the surgeon to figure out where he or she should stick the needle.  The real question is why were the drains removed if the output was so high?   More questions than answers in this case.  Best wishes to you!

Heather Rocheford, MD · Answer

First of all thank you for the question.  A seroma after removing drains is not too uncommon.  In general if you have a fluid wave, you may have a seroma that would need to be drained.  The reason being, is that we do not want you to accumulate too much fluid that would stretch the abdomen out and effect your results.  It is typically easy to identify.  Once identified the fluid would be aspirated.   I would recommend following up with your surgeon and discuss your concerns and options. Best of Luck.

Mark A. Schusterman, MD, FACS · Answer

Sorry to hear about your problem.  As others have said, I prefer to drain a seroma as soon as it is clinically evident or it might get infected and cause a bigger problem.  Hope this helps.

Michael McNeel, MD, FACS · Answer

Sorry to hear of your difficulty after your tummy tuck. A seroma is a collection of fluid under the skin that can accumulate after a procedure. If a patient gets a seroma after an abdominoplasty, I prefer to drain them, no matter the size. Typically if a seroma can be identified, it can be drained. Sometimes this may be done every 3-4 days.The benefit of draining an abdominal seroma after an abdominoplasty is that the seroma can cause a long term fullness that can limit your results.The presence of a seroma is typically easy to identify as your abdominal skin may have a fluid wave to it when you press on one side.If you feel like you have one, I think your plastic surgeon would like to know and you should inform them and follow their advice.Good luck with your recovery.

How big does a seroma need to be before it can be drained?

Answers (4)

Answer: Seroma after tummy tuck

Answer: Seroma after tummy tuck

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How big does a seroma need to be before it can be drained?

Answers (4)

Answer: Seroma after tummy tuck

Answer: Seroma after tummy tuck

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