When should an ultrasound be done to know if surgery is needed to remove fluid pocket? (photo)

Question

I'm 5"11, after two pregnancies with 60lbs on & off within 5 years I opted to have mommy make over. My surgery was 4/13/14, I had 2 tubes after which 1 was pulled 3 weeks and 2nd pulled 6 weeks later. Before the 2nd tube was pulled my dr inserted anti biotic fluid 2 separate occasions to try to collapse skin to tissue and stop fluid bc it wasn't reducing. In last two weeks I've been aspirated 3 times with a needle removing 120cc, 110cc, & 85cc. Im going in Wednesday again for more fluid removal.

Vincent N. Zubowicz, MD · Answer

. Your clinical course is fairly unusual.You seem to have developed a chronic seroma and reoperation may be necessary to remove the pseudocapsule forming is a byproduct of the complication. Ultrasound would be of no value since the fluid has already been diagnosed.

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

Thank you for your picture. You could do an ultrasound to determine if fluid is present but it would be an extra cost. You have a history of having fluid and a physical exam is a very good way of detecting the presence of fluid.  You may need to have surgical removal of the fluid pocket with replacement of the drain to eliminate the issue.Good luck. 
Earl Stephenson, Jr, M.D., DDS, FACS

Timothy Connall, MD, FACS · Answer

Fluid collections after tummy tuck surgery can be difficult problems to manage.  I am sorry to hear you have had to deal with this.  If the fluid collection is obvious on physical examination, then an ultrasound will not add much information.  A drain, in the form of a small catheter, can be inserted and kept in until the drainage resolves.  Compression, in the form of an Ace wrap, liposuction garment, or abdominal binding might also be helpful.

Darryl J. Blinski, MD · Answer

Sounds like a seroma fluid cavity. Maybe ultrasound guide re insertion of drainage system is needed. Now is time to consider that or re operation...

George Commons, MD (retired) · Answer

Your course is somewhat prolonged but every surgeon has seen a few people go 6 weeks or so and need drainage.    Some surgeons use drains after tummy tuck and some surgeons use no drains after tummy tuck.  I have practiced for over 30 years and have used drain less and less and now sometimes zero.   Obviously drains do not end the potential of seroma.    Seromas are easy to find and simple palpation  (feeling around) easily defines  them in a person as slender as you are.    I think with daily drainage and a tight abdominal binder for compression you will heal and seal and the seroma will be gone.   In 30 years I have never had to take a seroma  patient back to the OR.  They have all cleared with time and the regimen of 24/7 compression and daily drainage really seems to work.   I bet you will not have to go back to surgery.   My Best,  Dr C

Vincent D. Lepore, MD (retired) · Answer

I am sorry to hear you are having difficulty with what I believe is a persistent post operative seroma.  A seroma can occur after any abdominoplasty, even if drain tubes were used in the surgery.  If the seroma persists after several attempts at aspiration, your surgeon may want to consider replacing the suction drains.  Although an ultrasound may aid in determining the size and exact location of the seroma, the decision to replace the drains is a clinical one, and doesn't necessarily require an ultrasound exam.  Discuss this option with your surgeon and ask if he/she feels that an ultrasound exam would be of help in your case.  Best wishes, Dr Lepore.

When should an ultrasound be done to know if surgery is needed to remove fluid pocket? (photo)

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