What can I do about excess draining 4 months after my tummy tuck? I still have a drain in due to a seroma I developed.

Great questions. First, the likelihood of permanent damage or a serious problem is very low in cases of seroma formation. This problem, a chronic and recurrent seroma, is something that occasionally happens with this type of surgery and there is no way to predict who will be affected before surgery. Treatment of seromas, as you have experienced, is primarily repeated drainage. Usually, the amount of drainage decreases over time if the drain is left in place, or the amount aspirated decreases each time the seroma is drained in the office. Some of the time, as your doctor said, the seroma will "dry up" which means it will resolve spontaneously. In my experience this happens more than we expect even with chronic seromas if we leave them alone for awhile. At 4 months it is possible that the seroma cavity has formed a lining, which we call a capsule or pseudocapsule. If that has happened it does make it more difficult to eliminate the seroma but there are options. One option is to sclerose the cavity by placing a medication into the cavity. The medication will stimulate your body to mount an inflammatory response that will in turn lead to healing of the cavity walls to itself. Another option is to reoperate through the same incision as your orginial procedure and remove the pseudocapsule and start the healing process with fresh tissue edges that are more likely to heal together. The good news is that no one has a seroma forever and that your results will be just as good as if you had not had the seroma. Talk these things over with your doctor. Hope this helps

Chronic seromas are rare complications associated with abdominoplasty surgery, but they can be quite frustrating when they do occur. I think removal of the drain is reasonable to give you a break, but there is a good chance you might require percutaneous aspirations and replacement of the drain or a seromacath. There have been some good studies showing the efficacy of introducing a sclerosing agent into the seroma such as doxycycline to help stimulate the walls of the seroma to "stick" together. In some cases, surgically removing the lining of the seroma is needed to effectively eliminate the fluid accumulation. 

Draining 4 months post-tummy tuck is rare.You may have developed a chronic seroma where a capsule (pseudo bursa) has formed surrounding the fluid collection.  It is reasonable to remove the drain to "give body rest from it."  However, it is likely that you will develop a recurrent seroma.  If a recurrent seroma occurs, you may require a formal debridement and placement of a drain.Please follow up with your plastic surgeon closely.Best regards.

Dear babybing67,

Thank you for your clinical post and
sorry to hear about your post tummy tuck delayed healing complication. A chronic and persistent seroma is rare but
certainly no uncomplication of tummy tuck surgery. Generally, closed drainage allows the
lymphatic system to gradually take over following the abdominoplasty
surgery. However, insert circumstances
persistent fluid will continue to drain and at 4 months you’re at risk of
forming a lining around the cavities being drained and this is called a bursa
or capsule. A seromatous capsule is
generally harder to completely eliminate as the smooth lining prevents the
edges from uniting together. Removing
the drain is a reasonable option to see if the body’s lymphatic system will
take over, however, if recurrent seromas occur you may need intermittent
percutaneous aspiration that is draining the seroma through the skin with a
needle or seroma catheter insertion with or without a sclerosing agent often
Tetracyclines to try and stimulate inflammation and close the bursa of the
seroma capsule which you can view as a dilated balloon within the skin. Ultimately, if the seroma and the seroma
capsule persist an operation through the same incision excising the seroma
capsule and allowing primary healing to occur again is sometimes the only
option.

At this time it is very important to
maintain a good relationship with your operative plastic surgeon to ensure that
adequate resolution and an excellent aesthetic result is achieved.

I hope this information is of some
assistance and best of luck.

To find out more, please visit the
link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto