A Had a Tummy Tuck in March and Developed a Seroma. It Was Being Drained Every Day for 3 Months/?

Question

I Had a Drain Put in for 2weeks. And it did not go away.So I had another surgery to remove the bursa that had developed the drains were left in for another 8days. A week later I developed another seroma on my lower abs and my upper belly button . I'm so frustrated please help. Is there another procedure thAt can be done to get rid of the seroma?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Recurrent seromas are difficult to deal with.  It sounds like the appropriate treatment has been done thus far.  The next treatment to perform would be to inject a medication (sclerosing agent) that will initiate an internal scarring process to seal off the cavity.  This may have to be performed more than once.Dr. ES

J. Brian Boyd, MD · Answer

Most of the injectable 'sclerosant' solutions for chronic (long standing) seromas don't actually work and are a complete waste of time. Seromas become chronic due to an inflammatory reaction in the walls of the space that contains them. It is worth trying infusions of Triamcilolone, a slow release steroid, which will inhibit the inflammation, and so reduce or abolish the fluid production. This works about two thirds of the time. In the most resistant cases the wound should be re-opened, the lining removed and the abdominal flap sutured down to the underlying muscle so as to eliminate the potential space. That's it.

Pablo Prichard, MD · Answer

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

Christopher L. Hess, MD · Answer

Seromas after tummy tucks happen.  Every plastic surgeon wishes they wouldn't but they do. If you've had a second surgery to remove the rind or capsule that is created around the seroma cavity and you continue to get serious drainage the next step is an irritating agent.   I like to use doxycycline.  This is injected into the drain and the drain is capped.  It causes an irritation in the cavity which allows the sides to stick down and seal off the cavity.  Other agents can be use but often  an interventional radiologist is needed.  There is help but you will have to be patient some more.

Jourdan Gottlieb, MD · Answer

Hard to fit a three month course into a few sentences, and hard to understand what if anything other than drain and surgery have been tried. 

	One consideration is sclerosis, injection of a caustic material (betadine, tetracycline, absolute alcohol among the options) is injected via the drain, allowed to dwell, and then removed. Sometimes this is done several times, with the goal being an inflammatory reaction to cause the walls of the seroma to attach to each other and stop secreting fluid.

	Discuss with your surgeon. Best wishes.

A Had a Tummy Tuck in March and Developed a Seroma. It Was Being Drained Every Day for 3 Months/?

Answers (6)

Answer: Persistant Seroma After Tummy Tuck

Answer: Persistant Seroma After Tummy Tuck

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Answer: Is Reverse Tummy Tuck Best Option?

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A Had a Tummy Tuck in March and Developed a Seroma. It Was Being Drained Every Day for 3 Months/?

Answers (6)

Answer: Persistant Seroma After Tummy Tuck

Answer: Persistant Seroma After Tummy Tuck

Answer: Is Reverse Tummy Tuck Best Option?

Answer: Is Reverse Tummy Tuck Best Option?

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.