Waterbed Effect Still Present After Doc Tried to Aspirate Abdomen and Came out Dry. Should I Worry?

Even if you had some old blood, you do not have an actively-enlarging hematoma. This is either old blood and serum, or seroma, both of which require the same treatment--aspiration one or more times, compression, and if not resolved in this fashion, replacement of drain, sclerodesis, and (rarely) re-operation for pseudobursectomy.

After a month, if these tissues haven't "stuck-down" yet, they become progressively less likely to do so, so there is some degree of urgency here. That being said, if your surgeon's partner was unable to hit the seroma, this is understandable since he did not do your surgery and does not know the exact thickness of your subcutaneous fatty layer. Most of the time seromas are easy to tap, but not always! Of course, your surgeon's partner did not want to stir up bleeding or go too deep and hit an intra-abdominal organ! So congratulate him for his caution.

Once your doctor returns, you should see him promptly and have this aspirated. It will be done through a mostly or completely numb area, so you need not be worried about discomfort. But it does need to be drained, especially if there is enough fluid for a waterbed effect. Best wishes!

As long as you're not having fevers or severe abdominal pain, it's okay to wait 5-7 days before attempting another drainage of the fluid.  A low salt diet and compression garments may help in the meantime.  However, in my experience seromas resolve after 4-6 weeks of serial aspiration of the fluid.

Seroma is fluid underneath the skin that can accumulate after tummy tuck.  It usually means that the abdominal skin has not stuck down to the underlying abdominal wall.
Compression and drains help prevent Seroma in the early post operative period.
It sounds at this point as though you may have a persistent Seroma. Frequent drainage is the best way to go.  Sometimes these will resolve with multiple drainages, but on occasion they can require reoperation to get rid of the scar tissue shell that surrounds the fluid.
If it has gotten worse since use saw your doctor's partner then I would ask to go in again and have him look at you once more.  If you think it is better or stable see your surgeon as soon as he returns.
Good luck to you.

It sounds like you have an ongoing seroma problem. If you are asking should you be worried about this being dangerous, then the answer is no.  You can safely wait until your plastic surgeon returns.

Sometimes the layer of fluid is so thin that it is very difficult to aspirated and then it's better to just let it be rather than keep trying and increase the risk infection or injury to one of the surrounding structures.  

While you wait continue to wear your compression garment.

 

From your description it seems likely that there is more fluid or that some has accumulated under your abdominoplasty flap. This is one of the more common complications of a tummy tuck. It is common that patients who do develop a seroma will need more than one aspiration. I would contact your plastic surgeon and make another appointment to have him check you. In the mean time wearing an abdominal binder and taking it easy can help prevent reaccumulation of fluid as well. Best of luck, Dr Kerr

I sounds like you have a residual seroma. The surgeon should tap at the lowest point of the wave with you standing. Since the area is largely numb it should not hurt. It sounds like the seroma was missed. Arrange to see your surgeon as soon as he gets back. These usually resolve with several painless taps and compression garments.

Peter A Aldea, MD
Memphis, TN

Small seroma usually resolve. Needle aspiration usually works.  Your doctor may want to try again and if he ccomes up dry just go with compression and close follow up.  He may order an ultrasound also. 

Thank you for the question.

Given your description, it is possible that you do have a seroma present. It may be that the plastic surgeon missed the full collection on the single aspiration attempt. It would behoove you to request another  follow up  visit in the near future to again rule out/aspirate a seroma if present. 

Rarely, a seroma cannot be located clinically;  an ultrasound guided drainage procedure may be indicated.

Best wishes.

What you are describing sounds like a seroma 4 weeks after tummy tuck.   Please followup with your PS when he/she returns.   In the mean time, wearing snug compression garments is key.   If indeed you are experiencing a seroma, it can be treatment with several methods including: in-office drainage and compressive therapy, or possible replacement of a new drain.   Best of luck.

Sounds like you have a seroma under the abdominal flap.  See your surgeon to aspirate the area again.  This will help prevent infection and contour abnormalities.   Donald R. Nunn MD  Atlanta Plastic Surgeon.