How Many Times Should I Expect to have a Seroma Drained Post Tummy Tuck?

Sorry to hear you have a seroma, although they are common after the tummy tuck procedure, they are also frustrating for patients to keep having their seroma drained. The amount of times you have to have it drained varies. It essentially has to do with how much fluid you have built up.  If the drainage continues, your surgeon may suggest for you to go in the OR and have a new drain put in.

My recommendation for you to limit your activity level and wear your compression garment until your seroma gets better. Best of luck to you.

To learn more, please visit our page on potential complications of a tummy tuck procedure.

A seroma is an accumulation of fluid under the skin that can occur after various kinds of plastic surgery. Seromas can interefere with healing of surgical site and may require drainage. Small seromas often dissolve on their own, however larger one may need to be drained with the needle and syringe to avoid problems.   However,  if precautions are taken, such as placement of the drains and compression graments seromas occur very rarely. In very rare situtations  drainage has to be repeated several times but that usually solves the problem. 

can require 3-5  aspirations over several weeks

wear compression

discuss having a new drain placed if it persists

Seromas are collections of fluid that can form under the skin after a tumm tuck. These may need to be drained in the office  several times until the fluid amounts are quite low. If the fluid persists, occasionally a drain may need to be replaced and injected with a special solution to prevent fluid accumulation. Discuss this in detail with your plastic surgeon as each case is unique.

Best wishes,

Dr.Bruno

Hello. Thanks for your question . Seromas are the most frequent minor complications in this type of surgeries. The number of punctures to drain a seroma can vary greatly from patient to patient . You must have as many punctures are necessary to reduce them to an amount that can be absorbed by your body.  Best Luck.

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 a seroma keeps recurring after an extended period of time of aspiration, It may be advisable to re-open the area and remove the entire capsule, both front and back walls of the capsule, otherwise it will come back.  Drains need to be used, possible tissue glue, internal sutures, use of an irritant to encourage the tissues to grow together. Best wishes,Pablo Prichard, MD

Your plastic surgeon is in the best position to help decide what the problem is and how to correct it.  Usually it takes no more than 3 times for the seroma to resolve.  If the fluid keeps collecting then a drainage tube may have to be re-inserted.  It the pocket is still there you may need to have the seroma capsule excised.  If you are draining less then 25 cc each time then it is likely that this will resolve on its own.  Once it is totally gone it will not come back.

How many times a seroma following a tummy tuck may need to be aspirated and how long it will take to resolve are dependent on multiple factors and, therefore, unpredictable. It is my philosophy to aspirate at least twice per week. Some patients may require just a few aspirations of the fluid over a week; some can require multiple aspirations over several weeks.

If it appears that there is not a pattern of decreasing amount of fluid aspirated over a period of time, then (re)insertion of a drain would be indicated. This can usually be done in the office under local anesthesia.

Once you have developed a seroma after a tummy tuck, it is rare to just have to drain it one time. Usually it will take around four or more weekly aspirations (taps) until fluid no longer accumulates. Fortunately this is not a surgical problem and is a nuisance that is easily dealt with in a quick office procedure. While you are in the seroma phase, do not do heavy exercise or walk extended amounts as this causes more fluid to build up. Also wear your compression binder until the seroma no longer returns.

We have come to believe that seroma, or fluid collections, after tummy tuck can be avoided and now we seldom use a drain. When a seroma does occur it can take three or more office aspirations, longer rest, and longer compression to get the situation resolved. With care they all get better, though the seroma is frustrating for both surgeon and patient.
Best of luck,
peterejohnsonmd