How Many Times Should a Seroma Be Aspirated After a Tummy Tuck?

I had a FTT on July 22nd and the PS removed my drains on July 30th. Since the 2nd of August he has been aspirating the seroma daily with the exception of Saturday. The most he's ever aspirated is 65cc's. It has been decreasing but it always comes right back after he aspirates. I have not been able to return to work. He said he feels that re inserting drains would not be effective at this point and that I should continue to see him daily for him to aspirate. Should I be concerned?

Doctor Answers 4

Seroma formation after Tummy Tucks

It is OK to be diligent and have it aspirated daily but the norm of practice is aspirating once every few days. If it keeps recurring you can have a drain placed. You had mentioned that the volume is decreasing. This is a good sign and it should stop soon. Please avoid heavy activities and wear a good compression garment. Hope this was helpful.

Orange County Plastic Surgeon
5.0 out of 5 stars 195 reviews

Tummy tuck and seroma formation

It sounds as if your surgeon is being extremely diligent. Althought I tend to aspirate seromas once or twice a week, I don't see anything wrong with repeated daily aspirations. IF this were to persist beyond 3 weeks I would likely advise placement of a drain. However, that is my opinion alone.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Seroms after Tummy Tuck

Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid.  If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma.  Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Seromas after Tummy Tucks can be prolonged.

I agree that there is nothing wrong with aspirating a seroma daily, (maybe a slightly increased risk of infecting it with the frequent aspirations) but I too only do it once or twice per week.      If it is coming back that quickly or in a large volume then I would recommend re-inserting a drain or two.

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 113 reviews

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