Seroma or loose skin? 7 wks post op full Tummy tuck with muscle repair. (photos)
Doctor Answers 2
Your "pouch" could be either loose skin or a seroma at 2 months post-op
I'm afraid that most of us on here won't be able to tell you more than you already know, which is that what you are seeing could be swelling, residual laxity and excess of the skin and fatty tissues, or a fluid collection, called a seroma. The only way to tell this for sure is to have a physical exam in person see if a "fluid wave" can be detected. If we see that "sloshy" kind of motion of the tissues when we push on them, that is called a "fluid wave," and that would mean that there is a fluid collection under the skin. This is not a life threatening thing as long as there is no infection, but you'll want to have it drained sooner rather than later to prevent the formation of what's called a "pseudobursa," or a tissue lined space that keeps the fluid there long term, or even permanently until addressed. Drainage of these things is pretty easy, it's done right in the office with local anesthesia, and there is no down time. Sometimes they come back, and we may have to drain them a few times before they finally resolve, but the good news is that if they are managed aggressively, they almost always resolve. It also appears as though you had drains in place after your tummy tuck, which means it is likely that you did not have an internal suturing technique, like progressive tension sutures, used during your tummy tuck. This makes the possibility of seroma a bit higher. In the event that you don’t turn out to have a seroma, the other possibilities of swelling or residual laxity of tissues will just need time to settle before any final determination can be made about what is going on, how bad it is, and what, if anything, needs to be done about it. It seems as though you flew from Texas to Miami for your surgery, which would mean that it is probably hard for you to return to see the surgeon who actually did your surgery for evaluation of this in person. I think it's important enough that any potential fluid collections be identified and treated promptly that you should find a local board certified plastic surgeon who has experience in body contouring surgery like this so that he or she can examine you and give you a better idea of what’s going on. If you need to have a seroma drained, he or she should be able to do that at the time, and you should go ahead and have it done to prevent any longer term problems. If it’s not a seroma, then as I said above, we will just need to wait and let things heal and tighten up a bit longer before deciding what, if anything, needs to be done next. Best of luck.
Diagnosing a seroma after a tummy tuck
Seromas typically develop 1-2 weeks after surgery, but if they go undiagnosed and untreated then they can persist for long periods of time. Some seromas will increase over time and this can lead to distension and stretching of the skin in the lower abdomen. If this is indeed what's happening, then you may also be noticing a feeling of heaviness in the area and there may be a palpable or visible fluid collection. Unfortunately it's not possible to confirm the presence or absence of a seroma from your pictures alone. I would recommend you see your doctor, or another plastic surgeon so that a physical examination can be performed.
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