The bottom of my tummy is like a waterbed after a tummy tuck, do I have a seroma? (photo)

Question

I had a tummy tuck with liposuction to various areas 2 weeks 1 day ago. I have recently noticed the bottom of my tummy is like a waterbed. You hit one side and the liquid waves across like a waterbed. I have seen a surgeon who poked it then had me in a half sit up position poke it again and say its fine no seroma just fluid. I'm so confused I thought a seroma was fluid? Will this go away on its own? I would just like to add i am very happy with the results of my tummy tuck! Thank you.

Marwan R. Khalifeh, MD · Answer

It is normal after any  operation for your body to produce
fluid.  In the tummy tuck operation, a drain is left for a week or
two.  When your body slows the fluid production down and the healing
occurs, your drains will stop producing this normal fluid.  Typically, the
surgeon will remove the drains after a week or two when the fluid reaches less
than 30 millimeters per day.  I give patient's a flow sheet to record the
fluid output on.

In about 1% of tummy tucks, after the drain is removed, the body
produces too much fluid and the fluid starts accumulating.  This is called
a seroma and this extra fluid needs to be drained.

Fortunately for the tummy tuck patient, the drainage procedure
is typically simple.  A small needle is inserted into the collection, and
the fluid is gently aspirated.  Seromas typically disappear after anywhere
between 2-5 aspirations.

Seromas do not typically affect the final outcome of the
surgery, but do require several more visits to the office to remove this extra
fluid.

Compression after aspiration of the seroma is recommended.

The seroma fluid will appear blood tinged in the first few weeks
after surgery, or will be clear if the seroma occurs later in the course. 
This is an important distinction between a seroma, which is a fluid
accumulation, and a hemotoma, which is a blood collection.  Both are
treatable, but a hematoma is a little harder to aspirate and may have a larger
risk of infection because bacteria grows better in blood than in the seroma.

Camille Cash, MD · Answer

A seroma is a collection of fluid and can sometimes occur after a tummy tuck.  It's not possible to tell from your photos if a seroma is present, but your description certainly describes the characteristics seen with them.  I encourage you to return to your plastic surgeon for an evaluation.

Darryl J. Blinski, MD · Answer

Your description is that of a post operative seroma, but very hard to see in the posted photos. Best to seek immediate IN PESON drainage from your surgeon before things become serious or dangerous. BTW did you have drains???

Joseph D. Alkon, MD · Answer

It is possible to have some fluid accumulated in your lower abdomen two weeks after a tummy tuck with liposuction.  A pocket of accumulated fluid below the skin is a seroma.  It is not possible to tell from your photos if this is a seroma, or not.  But, an examination in person should be able to determine this.  You should see your plastic surgeon for an in-person evaluation of this.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the tummy tuck operation; you are correct in that, you should end up with a very nice long-term outcome. The description is certainly consistent with the presence of a seroma but given that your plastic surgeon has aspirated the area it is possible that you are dealing with fluid in the soft tissues (swelling) as opposed to fluid in between the skin and underlying muscle layers (seroma).  Important will be continued close follow-up with your plastic surgeon who may or may not wish to repeat aspiration attempts, depending on your physical examination findings. Best wishes.

The bottom of my tummy is like a waterbed after a tummy tuck, do I have a seroma? (photo)

Answers (5)

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