3 weeks post FTT. Drains removed one week ago and swelling worsened. Yesterday, I noticed when I push on a large lump in my pubic area, I can see the fluid displace and come up in my lower left abdomen. I can see the "waterbed effect" when I lie down and push on parts of my lower abd. and the hard spot in my pubic area disappears and is flat again. PS tried aspiration (placed syringe in lower left abdomen) but nothing would come out. Could it be something else? What can I do?
Tummy Tuck Seroma? Fluid Won't Drain.
Doctor Answers 12
Sometimes a longer needle is needed to aspirate the seroma
Pablo Prichard, MD
Seroma after Abdominoplasty
Seromas Should Be Addressed-- Contact Your PS
When this situation arises, treatment usually consists of serial aspirations and the use of compression garments.At this point the abdomen is still numb and can be easily aspirated.This usually addresses the problem, but occasionally more aggressive treatment is necessary.
In cases where aspiration has been unsuccessful, drainage with ultrasonic guidance may be appropriate.Under these circumstances it may be appropriate to leave a drain in place. In other cases failed aspiration may indicate that the seroma isn’t clinically significant.
It’s safe to say that the vast majority of seromas are successfully treated with conservative management.For this reason, it’s important to maintain close contact with your plastic surgeon.
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Seroma (fluid) after tummy tuck
Historically, seromas have been the most common post operative complication of abdominoplastys. They generally respond to serial aspirations which, if the accumulation is substantial as it appears in your case, is not overly difficult to perform succesfully. It generally takes several aspirations and will require diminished activities along with compression. Other options involve placement of a seroma catheter - which is in essence replacing your drain to allow a continuous removal of the fluid.
It is imperative that the seroma is treated, since a chronic seroma cavity can significantly alter your post operative result with firmness and fullness above the surgical incision (which would require re-operation to remove the cavity). Certainly if your plastic surgeon cannot find the cavity, a radiologist can place the catheter with ultra sonic guidance. Many plastic surgeons have altered their technique over the past several years to leave more deep tissue on the abdominal fascia and not skeletonize it as was the technique in the past. Leaving that tissue allows for better re-absorption of fluid and, in my practice, has made what was once a common post-operative occurrence, a thing of the past.
Regardless, first things first - contact your surgeon and have that fluid removed asap.
Tummy tuck seroma; aspiration attempt failed. What to do now?
What needs to happen immediately (so this seroma cavity does not become permanent) is another attempt at aspiration. After over two decades of doing tummy tucks, I have had my fair share of seromas (and even a few after drains have been removed), but I have only failed to successfully aspirate 1 or 2 patients with extremely small seromas, or extremely thick subcutaneous fatty layers. Seromas large enough to have a visible fluid wave are able to be aspirated in virtually all patients, though in patients who have a very thick fat layer that a "normal" length needle would not reach through, I use a longer IV needle, or even spinal needle.
Surgical placement of a new drain (under local anesthesia) is pretty easy if needed, though the cost of doing this in the hospital or outpatient surgical center may be prohibitive if your surgeon does not have his own surgical facility.
"Letting this go" and not draining the seroma may cause you to develop a pseudobursa that requires general anesthesia to surgically remove. To prevent the need for this, see your surgeon again, promptly!
Seroma after Tummy Tuck / Abdominoplasty
Yes, it sounds like you have a persistent seroma or fluid collection under your skin. In most cases, the fluid can be drained by your plastic surgeon in the office by numbing the skin and then draining the fluid with a needle. However, sometimes it requires a radiologist to drain the fluid. In this procedure, the radiologist uses an ultrasound to look through the skin and see where the fluid collection is located. The radiologist can then place a drain directly into the fluid collection. It sounds like this is what you need to have done.
Seroma aspiration after tummy tuck is common
it is common to experience a seroma after a tummy tuck. often if your plastic surgeon can't aspriate from one area he can try aspirating from another area. also it is very important to keep your activity level to a minimum and wear a tight binder to keep pressure over this area.
sean younai, MD
Seroma after Tummy Tuck
Hello The Babycakes,
I am sorry you are having this very common but frustrating problem known as a seroma. I understand that your PS tried to aspirate it but was unsuccessful, however that doesn't mean that there isn't fluid there. It is important to remove the fluid, so please return to your doctor for a second attempt. If unsuccessful, you will need an ultrasound to find the fluid and perhaps have it drained at that time. I am sure that this problem will be fixed and you should go on to have a normal healing process after this seroma is treated.
Best of luck!
Seroma in abdomen 1 week after drain removal
What you are describing is typical for a seroma of the abdomen. There clearly is a significant amount of fluid present that should be able to be aspirated. If allowed to continue untreated, not only will the deformity become larger and more symptomatic, but this could develop into a chronic problem with a persistent enclosed and lined seroma cavity. This would then require surgery to treat.
I recommend that you re-contact your plastic surgeon and have him/her make another attempt at aspiration of this seroma. You may require several aspirations and possibly even re-insertion of a drain tube.