Small seroma after tummy tuck. Do I have to have it removed? (Photos)

Question

I had a tummy tuck in October of 2023 in Tijuana. The surgery went well but as I was healing I noticed a small bulging above my belly button. The longer I’m on my feet the more bulging is noticeable. My primary care doctor ordered an ultrasound because she thought it could be a hernia but it’s actually a small Seroma measuring 3.6 x 2.4 x 1 cm . I am not sure I want to go back to Tijuana to remove it but am having a hard time finding a surgeon here in Seattle area who will . I have been told this is a straight forward procedure. What will happen if I never have it removed?

Wayne I. Yamahata, MD · Answer

Small seromas will frequently absorb and resolve on their own, but as it has been a year and a half since your surgery, this is likely to persist.  Seromas can typically be treated by performing an aspiration with a small needle and syringe. This can be done as an office procedure using local anesthesia. Following aspiration the seroma may return. Occasionally they require a surgical excision to remove them. This is more common when they are left untreated for long periods of time

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question. I understand that you have been diagnosed with a small chronic seroma now approximately 1.5 years post op. In most instances this will not go away on its own or with simple drainage/aspiration because this far out after surgery, the body has formed a capsule (scar tissue layer) around the fluid collection to "wall it off". To effectively solve this, the seroma capsule must be removed. Most commonly and aesthetically, this is done through the existing abdominoplasty scars, although it could be done with more direct overlying incision (although this would leave a new, more notable scar). If not treated, it is possible it would stay the same. However, there is a small chance it may grow if further irritation/inflammation occurs in the area, and there is a also a small chance it may become infected if bacteria somehow find their way to the fluid collection. The next best step is continuing to look for a board certified plastic surgeon to see for an in person exam and surgical plan.

Good luck on your journey!

Good luck on your journey!

Donovan Rosas, MD · Answer

A noticeable seroma 1.5 years post op is unlikely to resolve on its own.

I would recommend aspiration to start. However, there is a risk of re-accumulation. If aspiration is unsuccessful, it may indicate potential organized seroma capsule which may necessitate surgical exploration.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Eric Swanson, MD · Answer

Usually a bulge in this location is caused by a hernia around the belly button or weakness of the muscles. It is rare to have a seroma persist. You could have it aspirated with a needle under ultrasound guidance. This can be repeated. If it does not resolve, surgery is needed to remove it. One of the disadvantages of going out of country for surgery is not having your surgeon handy to treat problems that come up.

Ira H. Rex III, MD · Answer

Leaving your seroma alone is usually quite safe.  Treatment can be a little tricky, and may be not so straightforward.

Farbod Esmailian, MD · Answer

It is very unusual to have a seroma this far out persist. If they are very confident of a seroma then the same hospital/center who did the ultrasound can aspirate this under ultrasound guidance. Given that you are more than a year out, I am not certain this would resolve with aspiration, but worth a try. If it does not resolve then a revision tummy tuck would be necessary to remove the capsule that has formed.

Hope that helps.

Hope that helps.

Gene Sloan, MD · Answer

If you have a seroma still present over a year after surgery it's probably there to stay. Typically the fluid is absorbed but the wall of scar tissue that develops around the seroma cavity stays, which can sometimes distort the overlying tissue. Not sure why your seroma would persist. The place your PCP sent you for the ultrasound probably has an interventional radiologist who can insert a drain with ultrasound guidance.  That may be the easiest approach.

Camille Cash, MD · Answer

A small seroma may heal on its own but it should be followed by your surgeon.  They will often resolve once aspirated.  It is typically recommended to wear compression after aspiration to help the area to heal closed. If left untreated it could potentially lead to infection.

Agustina Hilario Duran, MD · Answer

Hi, thanks for your question. I recommend you to visit a local plastic surgeon for aspiration or drainage. It’s a simple outpatient procedure. If left untreated, it could harden (forming a seroma capsule) or get infected, so follow up with a local board-certified plastic surgeon when possible.

Darryl J. Blinski, MD · Answer

Based on the two post photos, it appears you have a more than moderate of the upper abdomen only re-operation of complete tummy tech can improve this. Expect fees to range from $10,000-$15,000. It is not a simple procedure. It’s a complete revision. Best of virtual consult with.

Small seroma after tummy tuck. Do I have to have it removed? (Photos)

Answers (10)

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