Told Not to Wear Compression Garment and Be Active After Abdominoplasty/lipo. Now Have Seroma. What is the Treatment Guideline?

Every doctor has his/her own protocol for patients following surgical procedures based on their training and experience.  While wearing a compression garment may help decrease the risk of developing a seroma, it will not necessarily prevent it.  Small seromas will sometimes resolve on their own without the need for treatment.  Larger ones can be sucked out using a syringe and needle in the office.  If the seroma recurs several times after using the syringe and needle then it may become necessary to replace a drain into the area. 

Thanks for your post. Traveling 700 miles sure is a long way. You have to decide about returning to see your surgeon or a local plastic surgeon. Seroma is the most common adverse effect of tummy tuck in some studies. They need treatment and the sooner the better. Best wishes, Dr. Aldo.

Thanks for your question. I do recommend compression and limiting activity after the TT. This doesn't guarantee that there won't be fluid accumulating, but in my opinion it helps. My patients often comment that they feel more comfortable with it on at the beginning because of their swelling. Fortunately though, this can be managed without having to return to the OR (usually).

Many surgeons differ in their tummy tuck treatment guidelines after surgery.  I do recommend that patients limit their exercise and wear a garment for about a month after surgery.  I think this can decrease your risk of seroma.

Some surgeons use garment and some do not.  Normal daily activity should not significantly contribute to seromas. They can some times jsut happen.

I am sorry to hear about your seroma problems.  The use of compression garments falls about fifty fifty in terms of plastic surgeons who use them and those that do not.  The treatment options once a seroma occurs can vary from observation to percutaneous drainage to opening the incision to allow the seroma to drain and ultimately to reoperation.  You should be in contact with your plastic surgeon to see what he or she recommends and/or if there are any local options who you could visit.  Good luck, I hope this resolves quickly for you.

I will also limit activity for the first two weeks after surgery.  I tell  my patients very light normal activity.  If you push it too much during this time I think your chances of slow healing are increased.  A seroma may be a sign that you were too active but it also could be the result of other things that slow healing like smoking, aggressive liposuction of the flap, obesity, or early infection.  

If seromas are small to moderate, I leave them alone and let the body reabsorb the fluid.  If more significant I will place a needle to drain them, encourage pressure garments and limit activity.   I May need to repeat this a second time.  Seromas are not an uncommon Plastic Surgery issue And rest assured if you see a Plastic Surgeon , they will be able to handle it.

There are about as many treatment guidelines as there are surgeons, and really no protocols are proven best.

I do encourage patients to walk and be up as much as possible, but to ease on other exercise for a month. I usually advice the compression garment at least until a few days after the drain is out. 

The seroma should be addressed by a surgeon.  It is not likely to resolve on its own. Best wishes.