I Had a Tummy Tuck October 3 and Still Have a Seroma. Do I Need Surgery to Remove Capsule?

There has been no liposuction, and its been getting drained, twice a week, staying still and keeping it bound.Yes, for 3 months I've been a good sport.=o) We even put another drain in, seemed to work for awhile, but came back. It's not as big as before, maybe 4x4inches. I paid $12,000 which I know is on the high end, and now I'm being charged another $2000 to hopefully take care of the problem. Should I give it more time, keep draining it or surgery?

Doctor Answers 7

Seroma After Abdominoplasty

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I know 3 months seems forever when you are going through this. In 30 years I have seen 3-4 patients with a seroma requiring drainage for up to 4 months. Sclerosing agents rarely work on organized seromas although it never hurts to try. You may need surgery to remove the scar sac making the seroma and I would hope your surgeon would fix this at no cost. I find doing this for patients pays off many fold in future referrals and perhaps your surgeon can be convinced of this. We now use tension advancement sutures and seromas are no longer a problem so if you do have more surgery ask your doctor to use that technique.

Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Seroms after Tummy Tuck

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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
4.9 out of 5 stars 42 reviews

Excision of a seroma pocket

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Your plastic surgeon is in the best position to help decide what the problem is and how to correct it.  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.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews


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As stated by others, at this point either a sclerosing agent or reoperation are the best two options.  Repeated aspirations will not be effective if the seroma is not decreasing in size between the aspirations.

Seroma after tummy tuck.

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This is a definite challenge.  A seroma that develops and persists can certainly form a mature lining (or capsule). I would try a sclerosing agent another trial at a drain.  Removal of the capsule can always be a long term solution and I would also use a drain for a long time afterwards to make sure there is very little chance of another seroma forming.  Good luck.

Recurrent seroma

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That's a tough problem. I think that unless your surgeon uses a sclerosing solution it is unlikely to go away for good.

Treatment of a Fourth Month old Tummy Tuck Seroma

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No one can advise you better tan your surgeon who hopefully is still seeing you. He/she operated on you and should have the experience of managing your Seroma. Generally  speaking, persistent aspirations, need to put in per cutaneous drains without resolution of the serma suggest a chronic Seroma. You may want to consider irritating the lining by injecting an irritating sclerosng agent into it and see if that resolves the problem. If not, you would do best by having a small re-operation with excision of the Seroma walls and closing over drains. 

Good luck 

Peter A Aldea,MD

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.