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Ask a Plastic Surgeon / Abdominoplasty
Question 13
Question: I had a tummy tuck 6 weeks ago. My jp drains were removed after 1 week. I developed a seroma and was aspirated 5 days later, then 2 days later I had filled up again, so i had a flat open drain installed. that drain stayed in for another week, then was removed. my seroma is smaller, but still exists. the drain hole healed over, and the doctor opened it last week and let it drain again. My doctor says if I'm not healed by my next appointment in two weeks, he's going to cut me open and pack the hole with gauze, then leave it open until it heals. My question: is this the normal and necessary course of treatment? How can you make a hole heal by putting a foreign body in it? I'm very concerned. My doctor seems very irritated with me and i'm not comfortable asking him a lot of questions. Please advise. Thanks.
From: asm, oh 01/14/2008
Response: It is true that with recurrent seroma formation, the body develops a capsule around the area (like an envelope on the inside). The will prevent the front and back sides from healing together and a permanent fluid accumulation may develop. The only way around this is, not so much placing the foreign body but, rather, removing the capsule surgically and then allowing it to heal again from the beginning again. I have never had to resort to placing the gauze and letting it heal from the depths out except in the case of a major infection in the area. I would generally try to remove the capsule, place a drain and apply compression but leave everything in and on for longer this time (about 2 weeks or so depending upon drainage) before I resorted to an open approach as your surgeon has suggested. Again, there may be extenuating circumstances for him/her to suggest this course but I generally try a less risky approach first.
Submitted by: Dr. Gregory Caputy, Honolulu, HI Web site for Dr. Caputy
User Comments
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From: asm
State: oh
Posted: 01/14/2008
Subject: tummy tuck seroma
Comment: thank you doctor for your response. just so you know,
i do not have any infection, and i have been wearing my compression binder 24/7. i only take it off to shower.
my employer is wanting to know, if i do have more surgery, will i have to take more time off work? what is the recovery period for a procedure like this?
thanks
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