Will your body absorb a large seroma on its own? How to tell the difference in swelling compared to a large seroma? (photo)

Question

I developed a seroma one week after a TT with MR. It was drained once a week for 2 weeks. At 3weeks I was slightly swollen and still had the wave like motions when pressing on my abdomen. My surgeon told me that the seroma had resolved and that if there was any more fluid, my body would absorb it. While I do trust my surgeon, I am worried because now at 4 weeks post-op I am even more swollen. I hope its just the normal expected swelling after a TT and not a larger seroma!

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Seromas can usually be distinguished from swelling during physical examination. Sometimes, an attempt at needle aspiration of seroma fluid may be necessary. Rarely, imaging (such as CT scan or ultrasound) may be required.
 Generally speaking, abdominal wall "swelling" after tummy tuck may be related to:
1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary. 
3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  a complete skin redraping  to occur.
I hope this helps.

Robert F. Centeno, MD, FACS · Answer

It is difficult to address your concern without  a physical exam.  If you have a fluid wave you likely have a seroma and additional aspiration or a temporary drain would be helpful.  Small seromas can be absorbed without treatment, large ones need to be treated or a pseudobursa can develop.  Discuss this matter further with your surgeon.  Best wishes.

Darryl J. Blinski, MD · Answer

NO! NOT NORMAL!!! You need to be examined IN PERSON ASAP... Either by your surgeon or seek in person second opinion...

Will your body absorb a large seroma on its own? How to tell the difference in swelling compared to a large seroma? (photo)

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Will your body absorb a large seroma on its own? How to tell the difference in swelling compared to a large seroma? (photo)

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Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.